To characterize Escherichia coli ventilator-associated pneumonia VAP in intensive care unit ICU patients by determining antibioresistance and genotypic characteristics of E. Patients under mechanical ventilation for more than 72 h were screened for simultaneous presence of E. If present, E. Multisite E.
One hundred fifteen distinct E. B2 phylogenetic group was predominant, with high VF gene content and low antimicrobial resistance. Antimicrobial resistance diversity was observed in four patients with VAP. Among screened VF genes, iroN and sfa appeared important for lung infection. This is the first study establishing antibioresistance and genotypic characteristics of E.
These isolates are highly virulent specific extraintestinal pathogenic E. Lung is the first site of infection in intensive care unit ICU patients [ 1 ], and ventilator-associated pneumonia VAP is the most common life-threatening hospital-acquired infection despite considerable efforts to implement guidelines for its prevention [ 2 , 3 ]. Consequences of VAP include increased duration of mechanical ventilation and length of ICU and hospital stay [ 4 , 5 ], high morbidity and mortality [ 6 ], and increased antibiotic consumption and hospital costs [ 7 ].
Gram-negative bacteria GNB predominate in hospital-acquired pneumonia, and among them, Escherichia coli is the main Enterobacteriaceae involved in VAP [ 6 ]. Although a huge amount of data has accumulated on E. Given the worrisome increase in multidrug resistance among GNB including E.
Greater knowledge of genotypic and phenotypic characteristics of E. Phylogenetic analysis shows that E. Strains belonging to groups A and B1 are known to carry few genes encoding virulence factors VF , with weak extraintestinal pathogenicity [ 16 ], and are commonly multidrug resistant [ 17 ]. On the other hand, group B2 and D strains typically express numerous VF mediating bacterial adhesion and protection, cell host invasion, toxicity, and iron uptake [ 10 ], usually exert high extraintestinal pathogenicity [ 16 ], and are generally more susceptible to antibiotics [ 17 ].
