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Characterization of a Pathogenic Escherichia coli Strain Derived from Oreochromis spp. Farms Using Whole-Genome Sequencing
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Unusual "flesh-eating" strains of Escherichia coli

Hila Shaked1, Zmira Samra, Michal Paul

  • 1Unit of Infectious Diseases, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.

Journal of Clinical Microbiology
|October 5, 2012
PubMed

Insights

Monomicrobial necrotizing fasciitis caused by Escherichia coli is a rare but deadly infection. This study found that E. coli can cause severe necrotizing fasciitis, often in immunocompromised patients, with a high mortality rate.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Genetics

Background:

  • Monomicrobial necrotizing fasciitis (MNF) is typically caused by Group A Streptococcus or Staphylococcus aureus.
  • Escherichia coli (E. coli) is rarely implicated in MNF, usually appearing in polymicrobial infections like Fournier's gangrene.

Observation:

  • This study details seven cases of MNF caused by E. coli, a rare monomicrobial pathogen, over 18 months.
  • All affected patients were immunocompromised, with limbs being the most common site of infection.
  • E. coli was isolated from blood, fascia, or both in all cases, leading to fatal outcomes in all patients, with three deaths within 48 hours.

Findings:

  • Randomly amplified polymorphic DNA (RAPD) analysis revealed significant genetic diversity among the E. coli strains.
  • The cytotoxic necrotizing factor 1 (cnf1) gene was detected in two of three E. coli isolates from patients with MNF, but not in control strains.
  • The cnf2 gene was not detected in any of the isolates.

Implications:

  • Escherichia coli can be a cause of life-threatening necrotizing fasciitis.
  • The presence of the cnf1 toxin gene may be associated with the virulence of E. coli in causing severe soft tissue infections.
  • Further research is needed to identify risk factors, reservoirs, and transmission routes for cnf1-producing E. coli.

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