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Background <p>One third of patients with <i>Escherichia coli</i> bacteraemia develop a dysregulated inflammatory response (sepsis/septic shock). Our objective was to investigate whether specific microbiological determinants of <i>E. coli</i> are associated to presentation with sepsis/shock.</p> Methods <p>A matched case-control study was performed; 101 case-patients with <i>E. coli</i> bacteraemia presenting with sepsis (SEPSIS-3 criteria) and 101 control-patients with <i>E. coli</i> bacteraemia without sepsis were matched by service, sex, age, Charlson index, acquisition and source of the bacteraemia and empirical treatment. Whole genome sequencing of <i>E. coli</i> isolates was performed (Illumina MiSeq Inc.). Sequence type, serotype, <i>fimH</i> type, virulence factors, antibiotic resistance genes, plasmid replicons pathogenicity islands and prophages were determined. A multivariate model was built for presentation with sepsis/septic shock using conditional logistic regression. The predictive capacity on the observed data was measured with the area under the ROC curve (AUROC) with 95% confidence intervals (CI).</p> Results <p>Here we show that in the multivariate model (adjusted OR; 95% CI), the ST69 clone (7.53; 1.06-35.05) and <i>pic</i> gene (4.38; 1.53-12.54) are associated to presentation with sepsis/shock, while the genes <i>papC</i> (0.30; 0.12-0.74) and <i>fdeC</i> (0.18; 0.03-1.32) show a protective effect. The AUROC of this model is 0.81 (95% CI 0.74-0.87).</p> Conclusions <p>We identify <i>E. coli</i> bacterial factors associated with severe clinical presentation in patients with bacteraemia. Further studies would be needed to consider these factors as potential preventive or therapeutic targets.</p>

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A matched case-control study on Escherichia coli factors contributing to sepsis and septic shock in bacteraemic patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月12日

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  • Natalia Maldonado,
  • Inmaculada López-Hernández,
  • John Karlsson Valik,
  • Luis Eduardo López-Cortes,
  • Pedro María Martínez Pérez-Crespo,
  • Andrea García-Montaner,
  • Manuel Alcalde-Rico,
  • Adrián Sousa-Domínguez,
  • Alfredo Jover Sáenz,
  • Josune Goikoetxea,
  • Ángeles Pulido-Navazo,
  • Luis Buzón-Martín,
  • Ana Isabel Aller,
  • Lucía Boix-Palop,
  • Alfonso del Arco-Jiménez,
  • Alejandro Smithson-Amat,
  • Juan Manuel Sánchez Calvo,
  • Clara Natera- Kindelán,
  • José Mª Reguera Iglesias,
  • Carlos Armiñanzas-Castillo,
  • Fátima Galán-Sánchez,
  • Alberto Bahamonde,
  • Isabel Gea-Lázaro,
  • Cristian Castelló-Abietar,
  • Inés Pérez-Camacho,
  • Teresa Marrodán-Ciordia,
  • Berta Becerril-Carral,
  • Pontus Naucler,
  • Álvaro Pascual-Hernández,
  • Jesús Rodríguez-Baño,
  • Inmaculada López Hernández,
  • Luis Eduardo López-Cortés,
  • Pilar Retamar-Gentil,
  • Álvaro Pascual,
  • Jesús Rodríguez-Baño,
  • Joaquín Lanz García,
  • Pedro María Martínez Pérez-Crespo,
  • Ana Isabel Aller García,
  • Eva León Jiménez,
  • Juan Corzo Delgado,
  • María Teresa Pérez Rodríguez,
  • Fernando Barcenilla Gaite,
  • Ane Josune Goikoetxea Aguirre,
  • Miguel Montejo Baranda,
  • Ángeles Pulido Navazo,
  • Jordi Cuquet Pedragosa,
  • Cristina Labayru Echeverría,
  • María Ángeles Mantecón Vallejo,
  • Lucía Boix Palop,
  • Esther Calbo Sebastián,
  • Alfonso del Arco Jiménez,
  • Alejandro Smithson Amat,
  • Clara Natera Kindelán,
  • José María Reguera Iglesias,
  • Carlos Armiñanzas Castillo,
  • María del Carmen Fariñas Álvarez,
  • Fátima Galán Sánchez,
  • Alberto Bahamonde Carrasco,
  • Isabel Gea Lázaro,
  • Jonathan Fernández Suárez,
  • Inés Pérez Camacho,
  • Teresa Marrodán Ciordia,
  • Marta Arias Temprano,
  • Berta Becerril Carral,
  • Jesús Canueto Quintero,
  • Armando Reyes Bertos,
  • Antonio Sánchez Porto,
  • David Vinuesa García,
  • Marcos Guzmán García,
  • Patricia Jiménez Aguilar,
  • Juan Pasquau

摘要

Background

One third of patients with Escherichia coli bacteraemia develop a dysregulated inflammatory response (sepsis/septic shock). Our objective was to investigate whether specific microbiological determinants of E. coli are associated to presentation with sepsis/shock.

Methods

A matched case-control study was performed; 101 case-patients with E. coli bacteraemia presenting with sepsis (SEPSIS-3 criteria) and 101 control-patients with E. coli bacteraemia without sepsis were matched by service, sex, age, Charlson index, acquisition and source of the bacteraemia and empirical treatment. Whole genome sequencing of E. coli isolates was performed (Illumina MiSeq Inc.). Sequence type, serotype, fimH type, virulence factors, antibiotic resistance genes, plasmid replicons pathogenicity islands and prophages were determined. A multivariate model was built for presentation with sepsis/septic shock using conditional logistic regression. The predictive capacity on the observed data was measured with the area under the ROC curve (AUROC) with 95% confidence intervals (CI).

Results

Here we show that in the multivariate model (adjusted OR; 95% CI), the ST69 clone (7.53; 1.06-35.05) and pic gene (4.38; 1.53-12.54) are associated to presentation with sepsis/shock, while the genes papC (0.30; 0.12-0.74) and fdeC (0.18; 0.03-1.32) show a protective effect. The AUROC of this model is 0.81 (95% CI 0.74-0.87).

Conclusions

We identify E. coli bacterial factors associated with severe clinical presentation in patients with bacteraemia. Further studies would be needed to consider these factors as potential preventive or therapeutic targets.