UPEC strain characterization isolated from Mexican patients with recurrent urinary infections

Abstract

Introduction: Any microorganism is capable of causing urinary tract infections (UTI). However, Uropathogenic Escherichia coli (UPEC) is responsible for the majority of UTI. A variety of virulence genes have been identified in UPEC. Diverse epidemiological studies support that specific subsets of genes are characteristic of each E. coli uropathogenic subtype involved in the development of cystitis, pyelonephritis, and urosepsis. Methodology: Twenty-three E. coli strains isolated from women with cystitis, 25 from men with prostatitis were characterized according to serotype, virulence genes, PFGE profile and susceptibility antimicrobials. Results: E. coli O25:H4-ST131 was more frequently isolated from cystitis than prostatitis. The majority of cystitis strains presented almost all the virulence genes, contrary to 60% of prostatitis strains. The strains characterized by serology, PFGE and MLST and virulence profile showed that cystitis strains shared a lineage with their own genomic fingerprint, indicating that these strains derived from a common ancestor. The prostatitis strains showed serotypes diverse and much higher degree of genetic diversity, indicating that they are an unrelated group. More than 50% of isolates were resistant to at least 7 of the antimicrobials tested. Antibiotic-tolerant cells were observed, presenting with more frequency in response chloramphenicol, tetracycline, trimethoprim-sulfometoxazole and dicloxicillin. Conclusions: Persister cells can be detected from the beginning of the infection. The importance of these persister cells that exhibit multidrug tolerance is that a single surviving bacterium can initiate again an infection making it clinical relevant in the chronic urinary tract infection.

Effect and Analysis of Bacterial Lysates for the Treatment of Recurrent Urinary Tract Infections in Adults

“…Other studies addressing the serotyping of E. coli strains associated with UTIs have reported similar results, mentioning classical and non-classical UPEC serogroups. When the results of non-classical UPEC serogroups obtained here were compared, these were different from those reported by studies in Mexico and other countries [14][15][16][17][18][19][20]. Besides showing the differences between serogroups around the globe, these statements confirm the fact that certain strains, grouped by Clermont [21] in the E. coli commensal group, are involved in the reinfections of patients with UTIs [22].…”

Characterization of auto-agglutinating and non-typeable uropathogenic Escherichia coli strains

“…Based on genotyping, as on serotyping, O25 and O75 are included among the most frequent serogroups associated with UTI in our work and in others carried out in Mexico [17][18][19], China [6], India [20], Italy [24], Spain [25] Iran [26]. This suggests the importance, along with their wide distribution in different countries, of both serogroups and their epidemiological impact.…”

“…Both situations make it necessary to search for alternatives in the characterization of E. coli related to UTIs [1,7]. Data in the literature show that approximately 8-18% of UPEC strains cannot be typified by traditional serology [6,8,[17][18][19] an alternative in this regard is the use of molecular procedures. A PCR assay to identify genes associated with the expression of 14 somatic O antigens of UPEC strains isolated from urine was evaluated in this work.…”

“…In this regard, some studies of UTI carried out in China, India, Japan and Germany observed that E. coli serogroups O12, O15, O21, O26, O39, O42, O46, O51, O60, O74, O76, O77, O78, O83, O92, O102, O105, O117, O120, O135, O145, O149, O150, and O153 are not included in the classic UPEC serogroups [6,[20][21][22]. Some of these serogroups and others, such as O9, O11, O17, O29, O35, O70, O96, O100, O101, O127, O138, O152, and O154, have been reported in different studies in Mexico [17][18][19]. The presence of different serogroups in different countries could be related to autochthonous bacteria that are part of the intestinal biota and that incidentally may cause UTI [23].…”

Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity

“…Genetic diversity has been widely used to characterize populations of UPEC strains associated with several diseases of the urinary tract (Luo et al, 2012; Acosta-Pérez et al, 2015; Morales-Espinosa et al, 2016). The recurrence of UTIs at HIMFG was associated with several clones in the MDR-UPEC strains of phylogenetic groups D and B2, which are responsible for a majority of persistent UTIs.…”