Abstract
In patients with haematological malignancies, the bowel remains the main source of Escherichia coli bloodstream infections. We present the clinical example of recurrent bowel-blood translocations of E. coli with the unique virulence characteristics in a 55-year-old male with the diagnosis of acute myeloid leukaemia. The virulent factors profile of examined strains confirmed that the co-existence of genes papC, sfa, usp and cnf1, encoding virulence factors, predisposes E. coli to translocation from the gastrointestinal tract to the vascular bed. The close cooperation between haematologists and microbiologists is essential to improve the outcome of patients colonised with highly pathogenic strains.
Highlights
Treatment of haematological malignancies with high-dose chemotherapy leads to disruption of the mucosal epithelium and prolonged agranulocytosis
We present the clinical example of recurrent bowel-blood translocations of E. coli with the unique virulence characteristics in a 55-year-old male with the diagnosis of acute myeloid leukaemia
The aim of this study was to investigate whether the unique profile of E. coli virulence factors (VFs) determines the ability to cross GI-blood barrier and to cause recurrent episodes of bacteraemia
Summary
Treatment of haematological malignancies with high-dose chemotherapy leads to disruption of the mucosal epithelium and prolonged agranulocytosis. Weakening of the immune barriers makes the patients susceptible to lifethreatening bloodstream infections from their own microbiota (Cattaneo et al 2014; Hamalainen et al 2008; Olson et al 2014). The aim of this study was to investigate whether the unique profile of E. coli VFs determines the ability to cross GI-blood barrier and to cause recurrent episodes of bacteraemia. An answer to this question would allow design of specific preventive strategies aiming to reduce patients’ mortality due to E. coli bloodstream infections
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