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Journal of Clinical Microbiology, December 2008, p. 3906-3911, Vol. 46, No. 12
0095-1137/08/$08.00+0     doi:10.1128/JCM.00949-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology and Phylogenetic Distribution of the Escherichia coli pks Genomic Island{triangledown}

James R. Johnson,1,2* Brian Johnston,1,2 Michael A. Kuskowski,3,4 Jean-Philippe Nougayrede,5,6 and Eric Oswald5,6

Medical Service,1 Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Minneapolis, Minnesota,3 Department of Medicine,2 Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota,4 INRA, UMR 1225, F-31076 Toulouse, France,5 Université de Toulouse, ENVT, UMR 1225, F-31076 Toulouse, France6

Received 17 May 2008/ Returned for modification 1 August 2008/ Accepted 13 October 2008

Epidemiological and phylogenetic associations of the pks genomic island of extraintestinal pathogenic Escherichia coli (ExPEC), which encodes the genotoxin colibactin, are incompletely defined. clbB and clbN (as markers for the 5' and 3' regions of the pks island, respectively), clbA and clbQ (as supplemental pks island markers), and 12 other putative ExPEC virulence genes were newly sought by PCR among 131 published E. coli isolates from hospitalized veterans (62 blood isolates and 69 fecal isolates). Blood and fecal isolates and clbB-positive and -negative isolates were compared for 66 newly and previously assessed traits. Among the 14 newly sought traits, clbB and clbN (colibactin polyketide synthesis system), hra (heat-resistant agglutinin), and vat (vacuolating toxin) were significantly associated with bacteremia. clbB and clbN identified a subset within phylogenetic group B2 with extremely high virulence scores and a high proportion of blood isolates. However, by multivariable analysis, other traits were more predictive of blood source than clbB and clbN were; indeed, among the newly sought traits, only pic significantly predicted bacteremia (negative association). By correspondence analysis, clbB and clbN were closely associated with group B2 and multiple B2-associated traits; by principal coordinate analysis, clbB and clbN partitioned the data set better than did blood versus fecal source. Thus, the pks island was significantly associated with bacteremia, multiple ExPEC-associated virulence genes, and group B2, and within group B2, it identified an especially high-virulence subset. This extends previous work regarding the pks island and supports investigation of the colibactin system as a potential therapeutic target.

* Corresponding author. Mailing address: Infectious Diseases (111F), VA Medical Center, 1 Veterans Drive, Minneapolis, MN 55417. Phone: (612) 467-4185. Fax: (612) 727-5995. E-mail: johns007{at}umn.edu

{triangledown} Published ahead of print on 22 October 2008.

Journal of Clinical Microbiology, December 2008, p. 3906-3911, Vol. 46, No. 12
0095-1137/08/$08.00+0     doi:10.1128/JCM.00949-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.



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