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They were classified into pathotypes based on virulence gene profiles. We constructed a phylogenetic tree based on cgSNPs. Synteny analysis on the LEE pathogenicity island was performed, and enriched accessory gene repertoires in particular hybrid-pathotypes were identified. Bacterial virulence was measured by lactate dehydrogenase (LDH) cytotoxicity assays. Genetic factors associated with increased cytotoxicity in the LDH assay were identified using SPLASH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 192 intestinal pathogenic\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates, 63 hybrid pathotype isolates (38 STEC\/EPEC, 23 STEC\/ETEC, and 2 STEC\/EAEC) were identified. Two main groups of STEC\/EPEC hybrid-pathotype isolates and one major STEC\/ETEC group were identified. Both groups of STEC\/EPEC hybrid isolates were closely associated with EPEC mono-pathotype isolates, and most STEC\/ETEC hybrid groups clustered with STEC mono-pathotype isolates. Synteny analysis on the LEE pathogenicity island also showed that some STEC\/EPEC hybrids might originate from EPEC genomic backbone. Based on the LDH assay, cytotoxicity was higher in STEC\/ETEC, but lower in STEC\/EPEC. Five gene modules (adhesion-pili, plasmid conjugation, flagella-motility, iron uptake, and T3SS) were identified to be genetic factors correlated with increased cytotoxicity in STEC\/ETEC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      High prevalence of hybrid-pathotype\n                      <jats:italic>E coli<\/jats:italic>\n                      isolates was identified. They might emerge repeatedly by independent incorporation of additional virulence factors, and genomic backbones and cytotoxicity differed according to the specific hybrid pathotype.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12929-026-01243-0","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T10:52:37Z","timestamp":1776077557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of hybrid-and mono-pathotype Escherichia coli isolates from South Korea based on whole genome analysis and cytotoxicity assay"],"prefix":"10.1186","volume":"33","author":[{"given":"Jong Hyun","family":"Shin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min Seok","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Young","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunju","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun Taek","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi-Ran","family":"Seo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Hyun","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeun-Jun","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyeri","family":"Seok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hae Suk","family":"Cheong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ki-Tae","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo Kyeung","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheol-In","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doo-Ryeon","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongwoo","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwan Soo","family":"Ko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"1243_CR1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1038\/nrmicro818","volume":"2","author":"JB Kaper","year":"2004","unstructured":"Kaper JB, Nataro JP, Mobley HL. 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