{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:35:40Z","timestamp":1790922940002,"version":"4.1.0"},"reference-count":83,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2014,2,1]],"date-time":"2014-02-01T00:00:00Z","timestamp":1391212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Uropathogenic\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            (UPEC) is the most common cause of community- and hospital-acquired urinary tract infections (UTIs). Isolates from uncomplicated community-acquired UTIs express a variety of virulence traits that promote the efficient colonization of the urinary tract. In contrast, nosocomial UTIs can be caused by\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            strains that differ in their virulence traits from the community-acquired UTI isolates. UPEC virulence markers are used to distinguish these facultative extraintestinal pathogens, which belong to the intestinal flora of many healthy individuals, from intestinal pathogenic\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            (IPEC). IPEC is a diarrheagenic pathogen with a characteristic virulence gene set that is absent in UPEC. Here, we characterized 265 isolates from patients with UTIs during inpatient or outpatient treatment at a hospital regarding their phylogenies and IPEC or UPEC virulence traits. Interestingly, 28 of these isolates (10.6%) carried typical IPEC virulence genes that are characteristic of enteroaggregative\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            (EAEC), Shiga toxin-producing\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            (STEC), and atypical enteropathogenic\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            (aEPEC), although IPEC is not considered a uropathogen. Twenty-three isolates harbored the\n            <jats:italic>astA<\/jats:italic>\n            gene coding for the EAEC heat-stable enterotoxin 1 (EAST1), and most of them carried virulence genes that are characteristic of UPEC and\/or EAEC. Our results indicate that UPEC isolates from hospital patients differ from archetypal community-acquired isolates from uncomplicated UTIs by their spectrum of virulence traits. They represent a diverse group, including EAEC, as well as other IPEC pathotypes, which in addition contain typical UPEC virulence genes. The combination of typical extraintestinal pathogenic\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            (ExPEC) and IPEC virulence determinants in some isolates demonstrates the marked genome plasticity of\n            <jats:named-content content-type=\"genus-species\">E. coli<\/jats:named-content>\n            and calls for a reevaluation of the strict pathotype classification of EAEC.\n          <\/jats:p>","DOI":"10.1128\/jcm.02069-13","type":"journal-article","created":{"date-parts":[[2013,11,14]],"date-time":"2013-11-14T05:53:47Z","timestamp":1384408427000},"page":"407-418","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":132,"title":["Characterization of Escherichia coli Isolates from Hospital Inpatients or Outpatients with Urinary Tract Infection"],"prefix":"10.1128","volume":"52","author":[{"given":"Francisco","family":"Toval","sequence":"first","affiliation":[{"name":"Institute for Hygiene, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian-Daniel","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"Institute for Hygiene, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Vogel","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology and Hygiene, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Wagenlehner","sequence":"additional","affiliation":[{"name":"Clinic for Urology, Pediatric Urology and Andrology, University of Giessen, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Mellmann","sequence":"additional","affiliation":[{"name":"Institute for Hygiene, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Fruth","sequence":"additional","affiliation":[{"name":"Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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