A Fatal Case of Necrotizing Fasciitis Caused by a Highly Virulent Escherichia coli Strain

Table 1

List of virulence genes detected in this study and their known function.

Functional category	Gene	Activity/effect
Toxins	Cnf1	Causes cell necrosis by activation of GTPases of the Rho family [7] and induces dermal necrosis in rabbits [8]
	hlyA	-hemolysin that exhibits pore-forming activities in the membrane of erythrocytes and other cells leading to cell lysis [9]
	hra	Promotes agglutination of human erythrocytes and colonic cells, bacterial autoaggregation, enhanced biofilm formation, and aggregative adhesion [10]
	vat	Possesses a vacuolating cytotoxic activity on host cells [11]
Adhesins	fimA	Mediate a series of signaling events that affect bacterial invasion and promote pro- or anti-inflammatory events [12]
	fimH
	sfa
	papA
	papC
	papG
	kpsMTII	Involved in defense avoidance mechanism [13]
Siderophores	iroN	Involved in chelation and delivery of iron to bacteria which favor proliferation and enhance pathogenesis [14]
	fyuA
Other activities	ibeA	Plays a key role in invasion process, intramacrophage survival, and inflammatory response [15]
	chuA	Binds host hemoproteins and transfers the coordinated heme molecule into the bacterium periplasm, where an ABC transport system delivers it to the cytoplasm [16]
	iss	Increases resistance to serum [17]
	ompA	Serve various functions crucial to cell viability and activity, including structural support, catalysis, active transport, and passive diffusion [18]
	ompT
	traT	Confers resistance to the bactericidal activities of serum [19]
	yjaA	Involved in the stress response of E. coli to hydrogen peroxide and acid as well as in biofilm formation [20]