Commonality of adherent-invasive Escherichia coli isolated from patients with extraintestinal infections, healthy indivi
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ORIGINAL ARTICLE
Commonality of adherent-invasive Escherichia coli isolated from patients with extraintestinal infections, healthy individuals and the environment D. J. Astley 1 & N. Masters 1 & A. Kuballa 1 & M. Katouli 1 Received: 28 April 2020 / Accepted: 5 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Adherent-invasive Escherichia coli (AIEC) has been implicated as a microbiological factor in inflammatory bowel disease (IBD) pathogenesis. These strains are defined by their ability to adhere to and invade intestinal epithelial cells, and to survive and replicate in macrophages. We postulated that AIEC strains may commonly inhabit the gut of healthy individuals (HI), cause extraintestinal infections, and be found in sewage treatment plants (STP) and surface waters (SW). A total of 808 E. coli strains isolated from HI; patients with community-acquired urinary tract infection (CA-UTI), septicaemia and urosepsis; STP; and SW, showing a diffuse adhesion pattern to Caco-2 cells were included in this study. Typing of the strains using a combination of RAPD-PCR and PhPlate fingerprinting grouped them into 48 common clones (CCs). Representatives of each CC were tested for the ability to invade Caco-2 cells, survive and replicate in macrophages, and for the presence of six virulence genes commonly found among AIEC strains. Twenty CCs were deemed AIEC based on their ability to survive and replicate in macrophages, while encoding htrA, dsbA and clbA genes. These CCs primarily originated from HI and CA-UTI patients but were also detected in secondary locations including STP and SW. Strains lacking intramacrophagic survival and replication abilities were regarded as diffusely adhering E. coli (DAEC). Certain clones of AIEC are common in the gut of HI whilst promoting CA-UTI. The survival and persistence of AIEC in STP and SW may have serious public health ramifications for individuals predisposed to IBD. Keywords Adherent-invasive Escherichia coli . IBD . Public health . Extra-intestinal infection . Environmental waters
Introduction Collectively, ulcerative colitis (UC) and Crohn’s disease (CD) constitute idiopathic inflammatory bowel disease (IBD) [1, 2]. Both conditions encompass an ever-expanding global public health problem currently affecting more than 5 million individuals worldwide [3]. Although the precise mechanisms underlying IBD pathogenesis are yet to be fully understood, Escherichia coli has been implicated as a microbiological factor in disease pathogenesis [4–6]. Several studies have Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10096-020-04066-5) contains supplementary material, which is available to authorized users. * M. Katouli [email protected] 1
Inflammation and Healing Cluster, School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore DC, Queensland 4558, Australia
reported increases in the relative abundance of mucosaassociated E. coli among patients with UC, CD and colorectal cancer (C
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