Background This study sought to investigate associations between a virulence factors and phylogeny in all neonatal E. coli bloodstream infections from patients admitted to the neonatal intensive care unit at Uppsala University Hospital between 2005 to 2020. Methods A total of 37 E. coli isolates from 32 neonates were whole genome sequenced and analysed for virulence factors related to extraintestinal E. coli, patient-related data were collected retrospectively in the medical records. Results E. coli isolates that belong to phylogroup B2 were associated with mortality (OR 26, p < 0.001), extreme prematurity with delivery before gestational week 28 (OR 9, p < 0.05) and shock (OR 9, p < 0.05) compared with isolates of non-B2 group. Female neonates were more often infected by isolates of phylogroup B2 E. coli compared with male neonates (OR 7, p = 0.05). The identification of the genotoxin determinant clb coding for colibactin exhibited strong associations with mortality (OR 67, p < 0.005), gestational age (OR 18, p < 0.005), and shock (OR 26, p < 0.005). Discussion The study highlighted the correlation between neonatal E. coli bacteraemia caused by phylogroup B2 and the role of colibactin. Moreover, it emphasised sex-based differences in bloodstream infections among the bacterial population of E. coli.

中文翻译：

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瑞典乌普萨拉县侵袭性新生儿大肠杆菌的全基因组测序


背景 本研究旨在调查 2005 年至 2020 年乌普萨拉大学医院新生儿重症监护病房收治的所有新生儿大肠杆菌血流感染的毒力因子与系统发育之间的关联。方法从 32 个样本中分离出总共 37 株大肠杆菌。对新生儿进行全基因组测序并分析与肠外大肠杆菌相关的毒力因子，并在病历中回顾性收集患者相关数据。结果 属于系统群 B2 的大肠杆菌分离株与死亡率（OR 26，p < 0.001）、妊娠第 28 周前分娩的极度早产（OR 9，p < 0.05）和休克（OR 9，p <）相关。 0.05）与非B2组分离株相比。与男性新生儿相比，女性新生儿更容易被 B2 系大肠杆菌分离株感染（OR 7，p = 0.05）。编码大肠杆菌素的基因毒素决定子 clb 的鉴定与死亡率（OR 67，p < 0.005）、胎龄（OR 18，p < 0.005）和休克（OR 26，p < 0.005）有很强的相关性。讨论 该研究强调了 B2 系统群引起的新生儿大肠杆菌菌血症与 colibactin 的作用之间的相关性。此外，它还强调了大肠杆菌细菌群体中血液感染的性别差异。