We present a relatively large series of Gram-negative monomicrobial NF, especially E. coli NF. However, the main limitation of
our study is its small size , as expected due to the rarity of this
infection. Significant inter-hospital variation in NF characteristics. including microbiology, has been described previously.3 In our
center, E. coli is one of the most common isolates in general, which
could explain its dominance in NF, as described for Klebsiella sp.
Further studies are needed to better characterize Gram-negative NF. Studies should examine the presence of cnf1 in E.
coli and other pathogenic factors in different Gram-negative
pathogens. The modes of transmission of this gene should be
detected in order to prevent its spread.