Genomic Dissection of an Enteroaggregative Escherichia coli Strain Isolated from Bacteremia Reveals Insights into Its Hybrid Pathogenic Potential

<i>Escherichia coli</i> is a frequent pathogen isolated from bloodstream infections. This study aimed to characterize the genetic features of EC092, an <i>E. coli</i> strain isolated from bacteremia that harbors enteroaggregative <i>E. coli</i> (EAEC) genetic markers, indicating its hybrid pathogenic potential. Whole-genome sequencing showed that EC092 belongs to phylogroup B1, ST278, and serotype O165:H4. Genes encoding virulence factors such as fimbriae, toxins, iron-uptake systems, autotransporter proteins (Pet, Pic, Sat, and SepA), and secretion systems were detected, as well as EAEC virulence genes (<i>aggR</i>, <i>aatA</i>, <i>aaiC</i>, and <i>aap</i>). EC092 was found to be closely related to the other EAEC prototype strains and highly similar in terms of virulence to three EAEC strains isolated from diarrhea. The genomic neighborhood of <i>pet</i>, <i>pic</i>, <i>sat</i>, <i>sepA</i>, and the EAEC virulence genes of EC092 and its three genetically related fecal EAEC strains showed an identical genomic organization and nucleotide sequences. Also, EC092 produced and secreted Pet, Pic, Sat, and SepA in the culture supernatant and resisted the bactericidal activity of normal human serum. Our results demonstrate that the strain EC092, isolated from bacteremia, is a hybrid pathogenic extraintestinal <i>E. coli</i> (ExPEC)/EAEC with virulence features that could mediate both extraintestinal and intestinal infections.