ASSOCIATION OF CARBOXYLESTERASE-B ELECTROPHORETIC PATTERN WITH PRESENCE AND EXPRESSION OF UROVIRULENCE FACTOR DETERMINANTS AND ANTIMICROBIAL RESISTANCE AMONG STRAINS OF ESCHERICHIA-COLI THAT CAUSE UROSEPSIS

We determined the carboxylesterase B electrophoretic profiles of 74 blood isolates of Escherichia coli from patients with urosepsis. Most strains (64%) exhibited the B2 electrophoretic pattern. P fimbrial and hemolysin genetic determinants were present and expressed significantly more often among strains with the B2 than with the B1 electrophoretic pattern. In contrast, aerobactin determinants were significantly more prevalent and more commonly expressed among the B1 strains; this difference was attributable to the presence of plasmid-encoded aerobactin in one-third of the B1 strains (P = 0.02, B1 versus B2). The prevalence and extent of antimicrobial resistance was significantly greater among the B1 strains, and the B1 electrophoretic pattern was more often found in isolates from patients with urinary tract abnormalities. We conclude that the carboxylesterase B electrophoretic pattern differentiates two groups of E. coli isolates from patients with urosepsis: strains with the B1 electrophoretic pattern are associated with urologically impaired hosts, characteristically lack P fimbrial and hemolysin determinants, and often carry a plasmid-encoded aerobactin system (possibly on multiple antimicrobial resistance plasmids), whereas B2 strains more commonly invade noncompromised hosts, express P fimbriae and hemolysin, carry chromosomal aerobactin determinants, and lack antimicrobial resistance.