Bacterial genome wide association study substantiatespapGIIofEscherichia colias a patient independent driver of urosepsis

Abstract

AbstractUrinary tract infections are extremely common and often caused byEscherichia coli. Bacterial virulence factors and patient characteristics have been linked separately to progressive, invasive infection. The interaction of these factors has however rarely been considered. We whole genome sequenced 1076E. coliisolates recovered from urine-or blood culture samples from 825 clinical cases. The majority of isolates belonged to the phylogroups B2 and D and encoded polysaccharide capsules. In line with previous studies, our bGWAS identifiedpapGIIto be associated with bacteraemia. In a generalised linear model correcting for patient characteristics,papGIIwas substantiated as a major contributor to invasive infection. Further, an independent cohort of 1,657 urine samples was PCR screened forpapGIIcarryingE. coli, confirming the increased relative frequency ofpapGII+ strains to cause invasive infection. This study builds on previous work linkingpapGIIwith invasive infection by showing that it is a patient-independent risk factor that has diagnostic potential.