{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T20:32:00Z","timestamp":1789590720195,"version":"build-2803163510"},"reference-count":16,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2012,12,1]],"date-time":"2012-12-01T00:00:00Z","timestamp":1354320000000},"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":[[2012,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Monomicrobial necrotizing fasciitis (type II) is typically caused by group A streptococcus alone or in combination with\n Staphylococcus aureus. Escherichia coli<\/jats:named-content>\n has been isolated from polymicrobial or Fournier's gangrene but has rarely been reported in monomicrobial necrotizing fasciitis. We describe the clinical characteristics and outcomes of seven cases of monomicrobial\n E. coli<\/jats:named-content>\n necrotizing fasciitis and\/or severe soft tissue infection diagnosed at a single institution during an 18-month period. Four isolates from three patients and two isolates from two patients with type I polymicrobial severe soft tissue infection (controls) were assayed by the randomly amplified polymorphic DNA (RAPD) analysis for fingerprinting and PCR amplification of primers in order to detect cytotoxic necrotizing factor 1 and 2 (\n cnf1<\/jats:italic>\n and\n cnf2<\/jats:italic>\n ) genes. All patients had some type of immune suppression. The limb was the most commonly involved organ. In all cases,\n E. coli<\/jats:named-content>\n was isolated as a monomicrobial pathogen from blood, fascia, or both. All patients died during hospitalization, three within the first 48 h. The RAPD amplification assay showed a high degree of genetic diversity among the \u201cflesh-eating\u201d strains and controls. The\n cnf1<\/jats:italic>\n toxin gene was identified in two out of three cases, but not in the controls.\n cnf2<\/jats:italic>\n was not detected in any of the patients.\n E. coli<\/jats:named-content>\n may be responsible for life-threatening necrotizing fasciitis. Further research is needed to reveal relevant risk factors, reservoirs, and modes of transmission of\n cnf1 E. coli<\/jats:italic>\n .\n <\/jats:p>","DOI":"10.1128\/jcm.02316-12","type":"journal-article","created":{"date-parts":[[2012,10,4]],"date-time":"2012-10-04T01:36:11Z","timestamp":1349314571000},"page":"4008-4011","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":29,"title":["Unusual \u201cFlesh-Eating\u201d Strains of Escherichia coli"],"prefix":"10.1128","volume":"50","author":[{"given":"Hila","family":"Shaked","sequence":"first","affiliation":[{"name":"Unit of Infectious Diseases, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zmira","family":"Samra","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Paul","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liora","family":"Madar-Shapiro","sequence":"additional","affiliation":[{"name":"Hy Labs, Rehovot, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of General Intensive Care, Rabin Medical Center, Campus Beilinson, Petah Tikva, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Pitlik","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihad","family":"Bishara","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2007.10.030"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199601253340407"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.39.3.1300-1306.1983"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc10278"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-443-06839-3.00218-6"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11751-011-0116-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.60.6.2182-2187.1992"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00491-10"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-0101(01)00149-0"},{"key":"e_1_3_2_11_2","first-page":"103","article-title":"Peripheral pyogenic arthritis. 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