O, K, and H antigens predict virulence factors, carboxylesterase B pattern, antimicrobial resistance, and host compromise among Escherichia coli strains causing urosepsis.

The O:K:H serotypes of 75 Escherichia coli blood isolates from patients with urosepsis were compared for the presence and expression of determinants for P fimbriae, hemolysin, and aerobactin; antimicrobial resistance; the carboxylesterase B phenotype; and associated compromising host conditions. O groups, K types, and O:K:H serotypes previously associated with urovirulence accounted for 69%, 60%, and 31% of the population, respectively. Chromosomal determinants for P fimbriae, hemolysin, and aerobactin were present in combination more commonly among strains belonging to urovirulence-associated O groups, K types, and O:K:H serotypes. Similarly, antimicrobial resistance was strikingly less prevalent, the B2 carboxylesterase phenotype more common, and associated host compromise less common among such strains. These data demonstrate that the O groups, K types, and O:K:H serotypes traditionally associated with urovirulence are prominent among E. coli strains causing urosepsis, in which they are associated with presence and expression of multiple chromosomal virulence factor determinants, susceptibility to antimicrobial agents, the B2 carboxylesterase phenotype, and noncompromised hosts.