Extra-intestinal Pathogenic Escherichia coli (ExPEC): Characteristics, Virulence Genes, Detection, and Control
Jeroen Geurtsen and Jan T. Poolman
from: Pathogenic Escherichia coli: Evolution, Omics, Detection and Control (Edited by: Pina M. Fratamico, Yanhong Liu and Christopher H. Sommers). Caister Academic Press, U.K. (2018) Pages: 47-70.
Extra-intestinal pathogenic Escherichia coli (ExPEC) are major human pathogens that carry combinations of genes encoding colonization factors and toxins that allow infection outside of the gastrointestinal tract, and that act to suppress host immune responses. Subgroups within the ExPEC family cause urinary tract infections, urosepsis, bacteraemia, and neonatal meningitis, and they may be associated with inflammatory bowel disease. However, clinical distinctions are blurred because ExPEC strains may cause disease in more than one site, and the genomic and phenotypic diversity amongst ExPEC has so far eluded clear-cut classification. A virulent, antibiotic-resistant clonal group called ST131 emerged and spread globally after 2000, and is now the most common cause of multi-resistant ExPEC infections worldwide. Antibiotic resistant ExPEC and the looming threat of a pan-resistant ExPEC strain represent a worldwide threat and the major challenge facing infection control in the 21st century. The availability of E. coli vaccines could reduce the prevalence of targeted strains and make positive inroads on antibiotic resistance levels. Advances in ExPEC infection control requires a better understanding of the interactions between pathogen and host and factors that drive fitness, transmissibility, and virulence read more ...