Phylogenetic and Pathotypic Comparison of Concurrent Urine and Rectal<i>Escherichia coli</i>Isolates from Men with Febrile Urinary Tract Infection

Johnson, James R.; Scheutz, Flemming; Ulleryd, Peter; Kuskowski, Michael A.; O'Bryan, Timothy T.; Sandberg, Torsten

doi:10.1128/jcm.43.8.3895-3900.2005

Cited by 52 publications

(44 citation statements)

References 45 publications

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“…Higher aggregate virulence scores have been observed in UPEC isolates than in fecal clones (21,27), suggesting that UPEC isolates harbor more virulence-associated factors. Although no single VF is sufficient for UPEC to cause infections, timely and stepwise expression of multiple, potentially redundant VFs can significantly contribute to UTI development (11).…”

Section: Discussionmentioning

confidence: 97%

Similarity and Divergence of Phylogenies, Antimicrobial Susceptibilities, and Virulence Factor Profiles of Escherichia coli Isolates Causing Recurrent Urinary Tract Infections That Persist or Result from Reinfection

Luo

Zhao

et al. 2012

J Clin Microbiol

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In order to obtain a better molecular understanding of recurrent urinary tract infection (RUTI), we collected 75 cases with repeatedly occurring uncomplicated UTI. The genetic relationships among uropathogenic Escherichia coli (UPEC) isolates were analyzed by pulsed-field gel electrophoresis. While 39 (52%) of the RUTI cases were defined as "persistence" of the same strain as the primary infecting strain, 36 (48%) were characterized by "reinfection" with a new strain that is different from the primary strain. We then examined the antimicrobial susceptibilities and phylogenetic backgrounds of 39 persistence and 86 reinfection UPEC isolates, and screened 44 virulence factor (VF) genes. We found that isolates had significant differences in the following: placement in phylogenetic group B2 (41% versus 21%; P ‫؍‬ 0.0193) and the presence of adhesin genes iha (49% versus 28%; P ‫؍‬ 0.0233) and papG allele I= (51% versus 24%; P ‫؍‬ 0.003), iron uptake genes fyuA (85% versus 58%; P ‫؍‬ 0.0037), irp-2 (87% versus 65%; P ‫؍‬ 0.0109), and iutA (87% versus 58%; P ‫؍‬ 0.0014), and an aggregate VF score (median, 11 versus 9; P ‫؍‬ 0.0030). In addition, 41% of persistence strains harbored three adhesin genes simultaneously, whereas 22% of reinfection isolates did (P ‫؍‬ 0.0289). Moreover, 59% versus 29% (P ‫؍‬ 0.0014) of persistence and reinfection isolates contained seven types of iron uptake genes. Taken together, the antimicrobial susceptibilities of UPEC isolates had little effect on the RUTI. Compared with reinfection strains, persistence UPEC isolates exhibited higher VF scores and carried more VF genes than may be involved in the development and progression of RUTI.A bout half of all women experience at least one urinary tract infection (UTI) during their lifetime, and UTIs are the second most common infection and account for nearly 25% of all infections in noninstitutionalized elderly populations (13). Moreover, about 25% to more than 40% of patients with UTIs experience recurrent UTI (RUTI) within weeks or months (3,11,13,16,32).As the most predominant pathogen, uropathogenic Escherichia coli (UPEC) causes almost 75 to 95% of episodes of uncomplicated UTIs (11,16). Some studies suggest that RUTI is primarily caused by a new strain that is quite different from the original strain (reinfection with a new strain) (4, 22). However, other studies indicate that most (50 to 78%) of the recurrent strains are indistinguishable compared with the original strains (persistence of the original strain) (12,14,18,24,37,39). The persistence of UPEC within the bladder could be due to the fact that UPEC strains can persist in the fecal flora for years and cause recurrent ascending UTIs (16). However, RUTI cannot be prevented by daily topical antibiotic treatment of the perineum, suggesting that RUTI does not require pathogen migration from the anus to the urinary tract (17). Furthermore, the intracellular bacterial reservoirs can persist for weeks to months within the urothelium, and intracellular biofilm-like collections of bacteria h...

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Section: Discussionmentioning

confidence: 97%

Similarity and Divergence of Phylogenies, Antimicrobial Susceptibilities, and Virulence Factor Profiles of Escherichia coli Isolates Causing Recurrent Urinary Tract Infections That Persist or Result from Reinfection

Luo

Zhao

et al. 2012

J Clin Microbiol

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“…However, the very small number of subjects (n ϭ 11) and fecal colonies (3 per host) examined in that study greatly limited the strength of these conclusions. Furthermore, the limited sampling of the fecal population in that study and previous similar studies involving girls (15,18), women (11), men (7), and dogs (5) with UTIs precluded valid assessment of the clonal diversity of the host's fecal population, which might be expected to vary with the nature of the colonizing clones and to influence the risk of UTI. Accordingly, in the present study we sampled a larger population of women with acute uncomplicated E. coli UTIs and analyzed 30 fecal E. coli colonies per host (i.e., 4 times as many subjects and 10 times as many colonies per host as in our pilot study).…”

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confidence: 84%

Relationship between Escherichia coli Strains Causing Acute Cystitis in Women and the Fecal E. coli Population of the Host

Moreno¹,

Andreu²,

et al. 2008

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Previous epidemiological assessments of the prevalence versus special-pathogenicity hypothesis for urinary tract infection (UTI) pathogenesis in women may have been confounded by underlying host population differences between women with UTI and healthy controls and have not considered the clonal complexity of the fecal Escherichia coli population of the host. In the present study, 42 women with acute uncomplicated cystitis served as their own controls for an analysis of the causative E. coli strain and the concurrent intestinal E. coli population. Clonality among the urine isolate and 30 fecal colonies per subject was assessed by repetitiveelement PCR and macrorestriction analysis. Each unique clone underwent PCR-based phylotyping and virulence genotyping. Molecular analysis resolved 109 unique clones (4 urine-only, 38 urine-fecal, and 67 fecal-only clones). Urine clones exhibited a significantly higher prevalence of group B2 than fecal-only clones (69% versus 10%; P < 0.001) and higher aggregate virulence scores (mean, 6.2 versus 2.9; P < 0.001). In multilevel regression models for predicting urine clone status, significant positive predictors included group B2, 10 individual virulence traits, the aggregate virulence score, fecal dominance, relative fecal abundance, and (unique to the present study) a pauciclonal fecal sample. In summary, within the fecal E. coli populations of women with acute cystitis, pauciclonality, clonal dominance, virulence, and group B2 status are closely intertwined. Phylogenetic group B2 status and/or associated virulence factors may promote fecal abundance and pauciclonality, thereby contributing to upstream steps in UTI pathogenesis. This relationship suggests a possible reconciliation of the prevalence and special-pathogenicity hypotheses.Urinary tract infection (UTI), one of the most frequent types of bacterial infection in women, is usually due to Escherichia coli (1). Despite considerable study, the pathogenesis of UTI remains poorly understood. The host's fecal (and, in women, vaginal) flora is the most common immediate source for the infecting E. coli strain (22, 26). However, uncertainty remains regarding to what extent the causative strains represent simply the most prevalent fecal/vaginal E. coli clones within the host population or the affected individuals (the prevalence hypothesis) (24) or, instead, represent a distinctive, highly selected subset of the fecal/vaginal E. coli population with enhanced virulence potential (the special-pathogenicity hypothesis) (18).Favoring the prevalence hypothesis, in acute E. coli UTI, the urine strain tends to be the host's predominant fecal strain (4,18,26). Favoring the special-pathogenicity hypothesis, acutephase UTI isolates usually exhibit more virulence factors than fecal isolates from healthy hosts and derive predominantly from phylogenetic groups B2 and D (versus groups A and B1 for fecal strains) (6,13,27). However, such comparisons may be confounded by between-population host differences, since women who develop UTIs tend to...

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“…coli strains, present in the large intestine are categorized into 4 phylogenetic groups typing, A, B1, B2 and D; these microorganisms may be commensal, which do not harm the host or may be pathogenic, belong to groups A and B1. On the other hand, pathogenic extra intestinal E. coli isolates chiefly belong to phylogenetic group B2 and, to a lesser extent, group D, these isolates harbor specialized virulence factors that aid their successful colonization in the mammalian urinary tract and are responsible for intestinal and extra-intestinal disease (2,5,8).…”

Section: Introductionmentioning

confidence: 99%

“…Although UPEC is an extracellular pathogen but can invade several types of bladder cell that compose the stratified layers of the bladder urothelium. Invasion to host cell simplifies both the establishment and persistence of UPEC in the urinary tract (5,6). UPEC also persist inside host urothelial cells in a more quiescent state, sequestered within late endosomal compartments (7).…”

Section: Introductionmentioning

confidence: 99%

Phylogenetic Groups and Pathogenicity Island Markers in Escherichia coli Isolated From Children

Navidinia

Peerayeh

Fallah

et al. 2013

Jundishapur J Microbiol

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Background: Uropathogenic Escherichia coli (UPEC) is a causative agent in most of the urinary tract infections (UTIs) which expresses a multitude of virulence factors. Objectives: In this study, we compared the presence of various PAI markers and phylogenetic groups in isolated E. coli from the urine of children with UTI and E. coli isolated from healthy children stool samples. Materials and Methods: A total of 100 E. coli isolates were collected from September 2009 to August 2010. Biochemical and standard microbiological methods were used to identify the UPEC and fecal E. coli isolates from healthy people. All isolates subjected to phylogenetic groups typing and examination for pathogenicity islands (PAI) by multiplex PCR. Results:We found a high number of PAI markers such as PAI ICFT073, PAI IICFT073, PAI I536, PAI IV536, PAI II J96 and PAI II536 significantly associated with UPEC. The PAI IV536 was the most detected ones among fecal E.coli isolated from healthy people while PAI I536, PAI II536 and PAI IJ96 were not seen. PCR phylogenetic groups typing revealed that uropathogenic strains were mainly found in B2 and D subgroups, while in fecal strains, A and B1 phylogenetic groups were the most common ones. Conclusions: To our knowledge, this is the first study of the phylogenetic groups typing and PAIs marker of UPEC and fecal E. coli in Iran.

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Phylogenetic and Pathotypic Comparison of Concurrent Urine and RectalEscherichia coliIsolates from Men with Febrile Urinary Tract Infection

Cited by 52 publications

References 45 publications

Similarity and Divergence of Phylogenies, Antimicrobial Susceptibilities, and Virulence Factor Profiles of Escherichia coli Isolates Causing Recurrent Urinary Tract Infections That Persist or Result from Reinfection

Similarity and Divergence of Phylogenies, Antimicrobial Susceptibilities, and Virulence Factor Profiles of Escherichia coli Isolates Causing Recurrent Urinary Tract Infections That Persist or Result from Reinfection

Relationship between Escherichia coli Strains Causing Acute Cystitis in Women and the Fecal E. coli Population of the Host

Phylogenetic Groups and Pathogenicity Island Markers in Escherichia coli Isolated From Children

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