Clinical and bacteriological specificities of Escherichia coli bloodstream infections from biliary portal of entries.

Escherichia coli Biliary tract infections Bloodstream infections Phylogeny Whole genome sequencing

Journal

The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675

Informations de publication

Date de publication:
12 Jan 2024
Historique:
received: 20 06 2023
revised: 13 12 2023
accepted: 18 12 2023
medline: 12 1 2024
pubmed: 12 1 2024
entrez: 12 1 2024
Statut: aheadofprint

Résumé

Escherichia coli is frequently responsible for bloodstream infections (BSI). Among digestive BSI, biliary infections appear to be less severe. Respective roles of host factors, bacterial determinants (phylogroups, virulence and antibiotic resistance) and portal of entry on outcome are unknown. Clinical characteristics and prognosis of 770 episodes of E. coli BSI were analyzed and isolates sequenced (Illumina technology) comparing phylogroups, MLST, virulence and resistance gene content. BSI isolates were compared with 362 commensal E. coli from healthy subjects. Among 770 episodes, 135 were biliary, 156 non-biliary digestive and 479 urinary. Compared to urinary, BSI of digestive origin occurred significantly more in men, comorbid and immunocompromised patients. Digestive portal of entry was significantly associated with septic shock and death. Among digestive infections, patients with biliary infections were dies less (P=0.032), despite comparable initial severity. Biliary E. coli resembled commensals (phylogroup distribution, ST group and few virulence-associated genes) whereas non-biliary digestive and urinary strains carried many virulence-associated genes. E. coli strains responsible for biliary infections exhibit commensal characteristics and are associatedd with lower mortality rates, despite similar initial severity than other digestive BSI. Biliary drainage in addition to antibiotics in the management of biliary infections may explain improved outcome.

Sections du résumé

BACKGROUND BACKGROUND
Escherichia coli is frequently responsible for bloodstream infections (BSI). Among digestive BSI, biliary infections appear to be less severe. Respective roles of host factors, bacterial determinants (phylogroups, virulence and antibiotic resistance) and portal of entry on outcome are unknown.
METHODS METHODS
Clinical characteristics and prognosis of 770 episodes of E. coli BSI were analyzed and isolates sequenced (Illumina technology) comparing phylogroups, MLST, virulence and resistance gene content. BSI isolates were compared with 362 commensal E. coli from healthy subjects.
RESULTS RESULTS
Among 770 episodes, 135 were biliary, 156 non-biliary digestive and 479 urinary. Compared to urinary, BSI of digestive origin occurred significantly more in men, comorbid and immunocompromised patients. Digestive portal of entry was significantly associated with septic shock and death. Among digestive infections, patients with biliary infections were dies less (P=0.032), despite comparable initial severity. Biliary E. coli resembled commensals (phylogroup distribution, ST group and few virulence-associated genes) whereas non-biliary digestive and urinary strains carried many virulence-associated genes.
CONCLUSIONS CONCLUSIONS
E. coli strains responsible for biliary infections exhibit commensal characteristics and are associatedd with lower mortality rates, despite similar initial severity than other digestive BSI. Biliary drainage in addition to antibiotics in the management of biliary infections may explain improved outcome.

Identifiants

pubmed: 38214565
pii: 7517610
doi: 10.1093/infdis/jiad586
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Investigateurs

Michel Wolff (M)
Loubna Alavoine (L)
Xavier Duval (X)
David Skurnik (D)
Paul-Louis Woerther (PL)
Antoine Andremont (A)
Etienne Carbonnelle (E)
Olivier Lortholary (O)
Xavier Nassif (X)
Sophie Abgrall (S)
Françoise Jaureguy (F)
Bertrand Picard (B)
Véronique Houdouin (V)
Yannick Aujard (Y)
Stéphane Bonacorsi (S)
Agnès Meybeck (A)
Guilène Barnaud (G)
Catherine Branger (C)
Agnès Lefort (A)
Bruno Fantin (B)
Claire Bellier (C)
Frédéric Bert (F)
Marie-Hélène Nicolas-Chanoine (MH)
Bernard Page (B)
Julie Cremniter (J)
Jean-Louis Gaillard (JL)
Françoise Leturdu (F)
Jean-Pierre Sollet (JP)
Gaëtan Plantefève (G)
Xavière Panhard (X)
France Mentré (F)
Estelle Marcault (E)
Florence Tubach (F)
Virginie Zarrouk (V)
Frederic Bert (F)
Marion Duprilot (M)
Véronique Leflon-Guibout (V)
Naouale Maataoui (N)
Laurence Armand (L)
Liem Luong Nguyen (LL)
Rocco Collarino (R)
Anne-Lise Munier (AL)
Hervé Jacquier (H)
Emmanuel Lecorché (E)
Laetitia Coutte (L)
Camille Gomart (C)
Ousser Ahmed Fateh (OA)
Luce Landraud (L)
Jonathan Messika (J)
Elisabeth Aslangul (E)
Magdalena Gerin (M)
Alexandre Bleibtreu (A)
Mathilde Lescat (M)
Violaine Walewski (V)
Frederic Mechaï (F)
Marion Dollat (M)
Anne-Claire Maherault (AC)
Mélanie Mercier-Darty (M)
Bernadette Basse (B)
Bruno Fantin (B)
Xavier Duval (X)
Etienne Carbonnelle (E)
Jean-Winoc Decousser (JW)
Raphaël Lepeule (R)
Monique Allouche (M)
Jean-Pierre Aubert (JP)
Isabelle Aubin (I)
Ghislaine Audran (G)
Dan Baruch (D)
Philippe Birembaux (P)
Max Budowski (M)
Emilie Chemla (E)
Alain Eddi (A)
Marc Frarier (M)
Eric Galam (E)
Julien Gelly (J)
Serge Joly (S)
Jean-François Millet (JF)
Michel Nougairede (M)
Nadja Pillon (N)
Guy Septavaux (G)
Catherine Szwebel (C)
Philippe Vellard (P)
Raymond Wakim (R)
Xavier Watelet (X)
Philippe Zerr (P)

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Aurélien Sokal (A)

Service de Médecine Interne, Hôpital Beaujon, Assistance-Publique des Hôpitaux de Paris (APHP), 92110 Clichy, France.

Guilhem Royer (G)

Université Paris Cité, INSERM, IAME, 75018 Paris, France.
Département de Prévention, Diagnostic et Traitement des Infections, Hôpital Henri Mondor, 94000 Créteil, France.
Unité Ecologie et Evolution de la Résistance aux Antibiotiques, Institut Pasteur, UMR CNRS 6047, Université Paris-Cité, 75015 Paris, France.

Marina Esposito-Farese (M)

Département d'épidémiologie, biostatistiques et recherche clinique, Hôpital Bichat, AP-HP, 75018 Paris, France.

Olivier Clermont (O)

Université Paris Cité, INSERM, IAME, 75018 Paris, France.

Bénédicte Condamine (B)

Université Paris Cité, INSERM, IAME, 75018 Paris, France.

Cedric Laouénan (C)

Université Paris Cité, INSERM, IAME, 75018 Paris, France.
Département d'épidémiologie, biostatistiques et recherche clinique, Hôpital Bichat, AP-HP, 75018 Paris, France.

Agnès Lefort (A)

Service de Médecine Interne, Hôpital Beaujon, Assistance-Publique des Hôpitaux de Paris (APHP), 92110 Clichy, France.
Université Paris Cité, INSERM, IAME, 75018 Paris, France.

Erick Denamur (E)

Université Paris Cité, INSERM, IAME, 75018 Paris, France.
Laboratoire de Génétique Moléculaire, Hôpital Bichat, AP-HP, 75018 Paris, France.

Victoire de Lastours (V)

Service de Médecine Interne, Hôpital Beaujon, Assistance-Publique des Hôpitaux de Paris (APHP), 92110 Clichy, France.
Université Paris Cité, INSERM, IAME, 75018 Paris, France.

Classifications MeSH