Skip to main content
Top
Published in: Infection 2/2014

01-04-2014 | Case Report

Diarrheagenic enteroaggregative Escherichia coli causing urinary tract infection and bacteremia leading to sepsis

Authors: K. Herzog, J. Engeler Dusel, M. Hugentobler, L. Beutin, G. Sägesser, R. Stephan, H. Hächler, M. Nüesch-Inderbinen

Published in: Infection | Issue 2/2014

Login to get access

Abstract

We report a case of a 55-year-old immunocompromised female who presented to the emergency department with severe diarrhea and vomiting following travel to the Philippines. Stool bacteriology revealed a mixed infection involving an enteropathogenic Escherichia coli and two distinct strains of enteroaggregative Escherichia coli (EAEC). During hospitalization, urine and blood culture tested positive for one of the diarrheagenic EAEC strains, necessitating urinary catheterization, intensive care, and antimicrobial treatment with trimethoprim–sulfamethoxazole, followed by meropenem. Although known to occasionally cause urinary tract infections, EAEC have not been previously associated with sepsis. Our report highlights the potential of EAEC to cause severe extraintestinal infections.
Literature
1.
go back to reference Huang DB, Nataro JP, DuPont HL, Kamat PP, Mhatre AD, Okhuysen PC, et al. Enteroaggregative Escherichia coli is a cause of acute diarrheal illness: a meta-analysis. Clin Infect Dis. 2006;43:556–63.PubMedCrossRef Huang DB, Nataro JP, DuPont HL, Kamat PP, Mhatre AD, Okhuysen PC, et al. Enteroaggregative Escherichia coli is a cause of acute diarrheal illness: a meta-analysis. Clin Infect Dis. 2006;43:556–63.PubMedCrossRef
2.
go back to reference Kaur P, Chakraborti A, Asea A. Enteroaggregative Escherichia coli: an emerging enteric food borne pathogen. Interdiscip Perspect Infect Dis. 2010;2010:254159.PubMedCentralPubMedCrossRef Kaur P, Chakraborti A, Asea A. Enteroaggregative Escherichia coli: an emerging enteric food borne pathogen. Interdiscip Perspect Infect Dis. 2010;2010:254159.PubMedCentralPubMedCrossRef
3.
go back to reference Rasko DA, Webster DR, Sahl JW, Bashir A, Boisen N, Scheutz F, et al. Origins of the E. coli strain causing an outbreak of hemolytic-uremic syndrome in Germany. N Engl J Med. 2011;365:709–17.PubMedCentralPubMedCrossRef Rasko DA, Webster DR, Sahl JW, Bashir A, Boisen N, Scheutz F, et al. Origins of the E. coli strain causing an outbreak of hemolytic-uremic syndrome in Germany. N Engl J Med. 2011;365:709–17.PubMedCentralPubMedCrossRef
4.
go back to reference Olesen B, Scheutz F, Andersen RL, Menard M, Boisen N, Johnston B, et al. Enteroaggregative Escherichia coli O78:H10, the cause of an outbreak of urinary tract infection. J Clin Microbiol. 2012;50:3703–11.PubMedCentralPubMedCrossRef Olesen B, Scheutz F, Andersen RL, Menard M, Boisen N, Johnston B, et al. Enteroaggregative Escherichia coli O78:H10, the cause of an outbreak of urinary tract infection. J Clin Microbiol. 2012;50:3703–11.PubMedCentralPubMedCrossRef
5.
go back to reference Murray PR, Baron EJ. Manual of clinical microbiology. Washington, D.C.: ASM Press; 2007. Murray PR, Baron EJ. Manual of clinical microbiology. Washington, D.C.: ASM Press; 2007.
6.
go back to reference Schmidt H, Knop C, Franke S, Aleksic S, Heesemann J, Karch H. Development of PCR for screening of enteroaggregative Escherichia coli. J Clin Microbiol. 1995;33:701–5.PubMedCentralPubMed Schmidt H, Knop C, Franke S, Aleksic S, Heesemann J, Karch H. Development of PCR for screening of enteroaggregative Escherichia coli. J Clin Microbiol. 1995;33:701–5.PubMedCentralPubMed
7.
go back to reference Bernier C, Gounon P, Le Bouguénec C. Identification of an aggregative adhesion fimbria (AAF) type III-encoding operon in enteroaggregative Escherichia coli as a sensitive probe for detecting the AAF-encoding operon family. Infect Immun. 2002;70:4302–11.PubMedCentralPubMedCrossRef Bernier C, Gounon P, Le Bouguénec C. Identification of an aggregative adhesion fimbria (AAF) type III-encoding operon in enteroaggregative Escherichia coli as a sensitive probe for detecting the AAF-encoding operon family. Infect Immun. 2002;70:4302–11.PubMedCentralPubMedCrossRef
8.
go back to reference Karch H, Böhm H, Schmidt H, Gunzer F, Aleksic S, Heesemann J. Clonal structure and pathogenicity of Shiga-like toxin-producing, sorbitol-fermenting Escherichia coli O157:H-. J Clin Microbiol. 1993;31:1200–5.PubMedCentralPubMed Karch H, Böhm H, Schmidt H, Gunzer F, Aleksic S, Heesemann J. Clonal structure and pathogenicity of Shiga-like toxin-producing, sorbitol-fermenting Escherichia coli O157:H-. J Clin Microbiol. 1993;31:1200–5.PubMedCentralPubMed
9.
go back to reference Peters TM, Maguire C, Threlfall EJ, Fisher IS, Gill N, Gatto AJ; Salm-gene project. The Salm-gene project—a European collaboration for DNA fingerprinting for food-related salmonellosis. Euro Surveill. 2003;8:46–50.PubMed Peters TM, Maguire C, Threlfall EJ, Fisher IS, Gill N, Gatto AJ; Salm-gene project. The Salm-gene project—a European collaboration for DNA fingerprinting for food-related salmonellosis. Euro Surveill. 2003;8:46–50.PubMed
10.
go back to reference Wirth T, Falush D, Lan R, Colles F, Mensa P, Wieler LH, et al. Sex and virulence in Escherichia coli: an evolutionary perspective. Mol Microbiol. 2006;60:1136–51.PubMedCentralPubMedCrossRef Wirth T, Falush D, Lan R, Colles F, Mensa P, Wieler LH, et al. Sex and virulence in Escherichia coli: an evolutionary perspective. Mol Microbiol. 2006;60:1136–51.PubMedCentralPubMedCrossRef
11.
go back to reference Afset JE, Bruant G, Brousseau R, Harel J, Anderssen E, Bevanger L, et al. Identification of virulence genes linked with diarrhea due to atypical enteropathogenic Escherichia coli by DNA microarray analysis and PCR. J Clin Microbiol. 2006;44:3703–11.PubMedCentralPubMedCrossRef Afset JE, Bruant G, Brousseau R, Harel J, Anderssen E, Bevanger L, et al. Identification of virulence genes linked with diarrhea due to atypical enteropathogenic Escherichia coli by DNA microarray analysis and PCR. J Clin Microbiol. 2006;44:3703–11.PubMedCentralPubMedCrossRef
12.
go back to reference Boisen N, Scheutz F, Rasko DA, Redman JC, Persson S, Simon J, et al. Genomic characterization of enteroaggregative Escherichia coli from children in Mali. J Infect Dis. 2012;205:431–44.PubMedCentralPubMedCrossRef Boisen N, Scheutz F, Rasko DA, Redman JC, Persson S, Simon J, et al. Genomic characterization of enteroaggregative Escherichia coli from children in Mali. J Infect Dis. 2012;205:431–44.PubMedCentralPubMedCrossRef
13.
go back to reference Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twenty-first informational supplement. CLSI document M100-S21. Wayne, PA: CLSI. 2011. Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing; Twenty-first informational supplement. CLSI document M100-S21. Wayne, PA: CLSI. 2011.
14.
go back to reference Boll EJ, Struve C, Boisen N, Olesen B, Stahlhut SG, Krogfelt KA. Role of enteroaggregative Escherichia coli virulence factors in uropathogenesis. Infect Immun. 2013;81:1164–71.PubMedCentralPubMedCrossRef Boll EJ, Struve C, Boisen N, Olesen B, Stahlhut SG, Krogfelt KA. Role of enteroaggregative Escherichia coli virulence factors in uropathogenesis. Infect Immun. 2013;81:1164–71.PubMedCentralPubMedCrossRef
15.
go back to reference Abe CM, Salvador FA, Falsetti IN, Vieira MAM, Blanco J, Blanco JE, et al. Uropathogenic Escherichia coli (UPEC) strains may carry virulence properties of diarrhoeagenic E. coli. FEMS Immunol Med Microbiol. 2008;52:397–406.PubMedCrossRef Abe CM, Salvador FA, Falsetti IN, Vieira MAM, Blanco J, Blanco JE, et al. Uropathogenic Escherichia coli (UPEC) strains may carry virulence properties of diarrhoeagenic E. coli. FEMS Immunol Med Microbiol. 2008;52:397–406.PubMedCrossRef
16.
go back to reference Navarro-Garcia F, Gutierrez-Jimenez J, Garcia-Tovar C, Castro LA, Salazar-Gonzalez H, Cordova V. Pic, an autotransporter protein secreted by different pathogens in the Enterobacteriaceae family, is a potent mucus secretagogue. Infect Immun. 2010;78:4101–9.PubMedCentralPubMedCrossRef Navarro-Garcia F, Gutierrez-Jimenez J, Garcia-Tovar C, Castro LA, Salazar-Gonzalez H, Cordova V. Pic, an autotransporter protein secreted by different pathogens in the Enterobacteriaceae family, is a potent mucus secretagogue. Infect Immun. 2010;78:4101–9.PubMedCentralPubMedCrossRef
Metadata
Title
Diarrheagenic enteroaggregative Escherichia coli causing urinary tract infection and bacteremia leading to sepsis
Authors
K. Herzog
J. Engeler Dusel
M. Hugentobler
L. Beutin
G. Sägesser
R. Stephan
H. Hächler
M. Nüesch-Inderbinen
Publication date
01-04-2014
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 2/2014
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-013-0569-x

Other articles of this Issue 2/2014

Infection 2/2014 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.