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Diarrheagenic and uropathogenic  E. coli  types are mainly characterized by the expression of distinctive bacterial virulent factors.  stx1 ,  stx2  (Shiga toxins), and  cdt  (cytolethal distending toxin) genes have been acquired by horizontal gene transfer. Some virulent genes such as  espP  (serine protease),  etpD  (part of secretion pathway), and  katP  (catalase-peroxidase), or  sfpA  gene (Sfp fimbriae), are on plasmids and the others like  fliC  (flagellin) and the  fimH  gene (fimbriae type-I) are located on chromosome. Genomic pathogenicity islands (PAIs) carry some virulent genes such as  hly  gene. To determine the existence of virulence genes in  cdt  clinical isolates, genes including  stx1 ,  stx2 ,  cdt ,  hly ,  espP ,  katP ,  sfpA ,  etpD ,  fliC , and  fimH  were assessed by Polymerase Chain Reaction (PCR). The most prevalent isolates for  etpD  and  katP  genes were 85.7% in  cdtII .  katP  gene was also observed 83.3% in  cdtI . However, in 42.85% of  cdtIII  isolates,  espP  gene was the most detected. Moreover,  hly  gene was also the most prominent gene in  cdtIII  (71.42%).  sfpA gene  was observed in 66.6% of  cdtV .  stx1  gene was detected in 100% of  cdtII ,  cdtIV , and  cdtV  types. Presence and pattern of virulence genes were considered among  cdt  positive isotypes and used for their clustering and profiling.

Genotype Cluster Analysis in PathogenicEscherichia coliIsolates Producing Different CDT Types