Mutating Escherichia coli caused multiple organ dysfunction syndrome

Pathogenic Escherichia coli is of great concern in the clinical setting. But few reports have demonstrated the variation in disease course. We present a severe case of multiple organ dysfunction syndrome caused by E. coli infection. Pathogens isolated from blood and urine samples harboured many virulence factors. Whole-genome sequencing and conventional analyses showed that the isolates experienced beneficial variations, both genetically and phenotypically, during the disease course. These findings showed that E. coli can cause systemic symptoms and informed us of the importance of assessing the reasons for such variations in pathogens occurring in vivo.