A newly developed PCR-based assay for the H7 variant of the Escherichia coli flagellin gene, fliC, was 100% sensitive and specific in comparison with serology and probe hybridization. It revealed broad conservation of the H7 fliC variant among phylogenetically diverse lineages of extraintestinal pathogenic E. coli (ExPEC) and superseded serotyping for certain isolates with ambiguous or non-H7 serotyping results. The H7 primers functioned well when incorporated into a multiplex PCR assay for diverse virulence-associated genes of ExPEC.The H7 flagellar variant of Escherichia coli recently has received increasing attention because of its diagnostic importance with respect to E. coli O157:H7 (8, 9, 25, 29, 31), the major cause of hemorrhagic colitis and hemolytic-uremic syndrome in the industrialized world (6,32,33). Inconsistent expression of the H7 antigen and the technical difficulties associated with H antigen serotyping have led to interest in PCR-based assays for detection of the H7 allele of the E. coli flagellin gene, fliC (8,9,25). Three such assays have been reported. One involves amplification of the entirety of fliC using consensus primers based on the conserved 5Ј and 3Ј extremes of fliC, with H7 specificity obtained via a subsequent restriction digestion step (8). The other two assays utilize H7-specific primers based on unique regions within the internal variable portion of fliC that presumably encode H7-specific antigenic epitopes (9, 25). All three assays are highly sensitive and specific for detection of the H7 fliC variant among E. coli O157:H7 and O55:H7 isolates, as well as in certain nonmotile (hence H antigen-negative) shigatoxigenic E. coli isolates of serotype O157 that presumably contain, but fail to express, fliC (8,9,25).However, the H7 flagellar antigen also characterizes several familiar "virulent clones" of extraintestinal pathogenic E. coli (ExPEC) (21,27,30). These include E. coli O1:K1:H7 and O2:K1:H7, serotypes traditionally associated with pyelonephritis and sepsis (16,21,27), and E. coli O18:K1:H7, a serotype traditionally associated with neonatal bacterial meningitis and neonatal sepsis but recently shown to be highly prevalent also in uncomplicated cystitis in adult women (1,4,12,15,21,22). Although an E. coli O1:H7 isolate (strain U5-41) actually was the source of the first published H7 fliC sequence (31), all three studies of PCR-based detection of the H7 fliC variant have focused on diarrheagenic E. coli, with scant attention given to ExPEC (8,9,25). In these studies the only putative ExPEC isolates examined were of serotypes O1:H7 and O18: H7. No information regarding K antigens was provided, few examples of each serotype were analyzed, and the clinical sources of the isolates were not specified (8,9,25).In the present study we designed and validated an H7-specific fliC PCR assay based on primers that could be incorporated into our established broad-range multiplex PCR assay for putative virulence factors (VFs) of ExPEC (11,19). We then used the PCR assay to assess the fliC...