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Neonatal meningitis Eschericha coli (NMEC), a sub-pathotype of extra intestinal E. coli (ExPEC), is one of the most common causative agents of neonatal bacterial meningitis (NBM). NBM is a devastating disease affecting neonates less than four weeks old, causing acute onset of sepsis and invasion of the central nervous system. Without treatment, NBM is almost certainly fatal, but early intervention and empiric treatment, as well as new broad spectrum antibiotics, have reduced the mortality rates from 32% in 1975 to as low as 8.5% in the United States. Recent studies have greatly improved knowledge of NMEC pathogenic mechanisms by characterizing multiple NMEC virulence factors; however, nearly all experiments were performed using a single NMEC strain, RS218, and its derivative mutants. Broader studies examining larger populations of NMEC have begun to show that some of the virulence factors critical for NMEC RS218 pathogenesis are uncommon in other NMEC, while other virulence factors identified using NMEC RS218 are present in multiple E. coli sub-pathotypes and even non-pathogenic E. coli. Such findings beg the questions, what genes define the NMEC sub-pathotype? How diverse are members of the NMEC sub-pathotype? And can another NMEC strain, other than NMEC RS218, serve as a more representative prototype of the NMEC group? Additionally, other studies have found that some Avian Pathogenic E. coli (APEC) strains can cause NBM in the rat model of human disease, while some NMEC are able to cause disease in the day-old chick model of avian colibacillosis. Such findings suggest that NBM and avian colibacillosis, caused by ExPEC, could be zoonotic

Genomic epidemiology and characterization of neonatal meningitis Escherichia coli and their virulence plasmids