Clinical and phylogenetic characteristics of Escherichia coli urinary tract infections

Lee, S.Y.; Kim, J.H.; Hur, Je Kyun; Kang, Jin-Han

doi:10.1016/j.ijid.2010.02.1978

Cited by 3 publications

(7 citation statements)

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“…As UTIs are the most common bacterial infection in children, it is especially important to identify the clinical significance and epidemiology of ST131 E. coli in pediatric UTI. UPEC strains recently isolated from Korean children belonged to phylogenetic groups B2 (61.6%–68.1%) and D (12.8%–26.8%), comprising the majority of all isolated strains 22 23) . In a Taiwanese study of infants hospitalized for community-acquired UTIs caused by ESBL-producing E. coli , ST131 accounted for 65% of the 111 isolates 6) .…”

Section: Discussionmentioning

confidence: 99%

UropathogenicEscherichia coliST131 in urinary tract infections in children

et al. 2017

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PurposeEscherichia coli sequence type (ST) 131, a multidrug-resistant clone causing extraintestinal infections, has rapidly become prevalent worldwide. However, the epidemiological and clinical features of pediatric infections are poorly understood. We aimed to explore the characteristics of ST131 Escherichia coli isolated from Korean children with urinary tract infections.MethodsWe examined 114 uropathogenic E. coli (UPEC) isolates from children hospitalized at Chung-Ang University Hospital between 2011 and 2014. Bacterial strains were classified into STs by partial sequencing of seven housekeeping genes (adk, fumC, gyrB, icd, mdh, purA, and recA). Clinical characteristics and antimicrobial susceptibility were compared between ST131 and non-ST131 UPEC isolates.ResultsSixteen UPEC isolates (14.0%) were extended-spectrum β-lactamase (ESBL)-producers; 50.0% of ESBL-producers were ST131 isolates. Of all the isolates tested, 13.2% (15 of 114) were classified as ST131. There were no statistically significant associations between ST131 and age, sex, or clinical characteristics, including fever, white blood cell counts in urine and serum, C-reactive protein, radiologic abnormalities, and clinical outcome. However, ST131 isolates showed significantly lower rates of susceptibility to cefazolin (26.7%), cefotaxime (40.0%), cefepime (40.0%), and ciprofloxacin (53.3%) than non-ST131 isolates (65.7%, 91.9%, 92.9%, and 87.9%, respectively; P<0.001 for all). ESBL was more frequently produced in ST131 (53.3%) than in non-ST131 (8.1%) isolates (P<0.01).ConclusionST131 E. coli isolates were prevalent uropathogens in children at a single medical center in Korea between 2011 and 2014. Although ST131 isolates showed higher rates of antimicrobial resistance, clinical presentation and outcomes of patients were similar to those of patients infected with non-ST131 isolates.

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Section: Discussionmentioning

confidence: 99%

UropathogenicEscherichia coliST131 in urinary tract infections in children

et al. 2017

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“…Sequence-based genotyping methods are becoming increasingly popular in epidemiological studies of infectious diseases such as UTIs. However, so far, only the conventional phylogrouping method have been used for analyzing clinical UPEC isolates from children with UTI in Korea 16 , 17) .…”

Section: Discussionmentioning

confidence: 99%

Molecular typing of uropathogenicEscherichia coliisolated from Korean children with urinary tract infection

Yun

Kim

et al. 2015

Korean J Pediatr

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PurposeWe investigated the molecular types of uropathogenic Escherichia coli (UPEC) by using conventional phylogrouping, multilocus sequence typing (MLST), and fimH genotyping.MethodsSamples of patients younger than 18 years of age were collected from the Chung-Ang University Hospital over 2 years. Conventional phylogenetic grouping for UPEC strains was performed by polymerase chain reaction (PCR). Bacterial strain sequence types (STs) were classified on the basis of the results of partial sequencing of seven housekeeping genes. In addition, we analyzed nucleotide variations in a 424-base pair fragment of fimH, a major virulence factor in UPEC.ResultsSixty-four UPEC isolates were analyzed in this study. Phylogenetic grouping revealed that group B2 was the most common type (n=54, 84%). We identified 16 distinctive STs using MLST. The most common STs were ST95 (35.9%), ST73 (15.6%), ST131 (12.5%), ST69 (7.8%), and ST14 (6.3%). Fourteen fimH allele types were identified, of which 11 had been previously reported, and the remaining three were identified in this study. f1 (n=28, 45.2%) was found to be the most common allele type, followed by f6 and f9 (n=7, 11.3% each). Comparative analysis of the results from the three different molecular typing techniques revealed that both MLST and fimH typing generated more discriminatory UPEC types than did PCR-based phylogrouping.ConclusionWe characterized UPEC molecular types isolated from Korean children by MLST and fimH genotyping. fimH genotyping might serve as a useful molecular test for large epidemiologic studies of UPEC isolates.

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“…To design an empirical treatment, it is important to consider the resistance pattern of Gram-negative fermenting bacteria, since this group is responsible for most UTIs. Resistance rates inferior to 20% are considered adequate for the empirical use of a certain antibiotic 30,31 . According to Rossi et al 32 , fosfomycin and nitrofurantoin are the first choices for uncomplicated cystitis, the most prevalent UTI.…”

Section: Coagulase-positive Staphylococcimentioning

confidence: 99%

Section: Coagulase-positive Staphylococcimentioning

confidence: 99%

“…Regarding the treatment of uncomplicated pyelonephritis, quinolones figure as the first choice 31,37 . However, if local resistance to these drugs is higher than 10% -as found in this study, the American College of Clinical Pharmacy suggests giving ceftriaxone 1 g IV once or a dose of an aminoglycoside 31 . Sulfamethoxazole+Trimethoprim is quite effective against this type of UTI, but it is no longer considered an ideal agent for the empirical treatment of pyelonephritis due to the increasing rates of resistance, as herein detected.…”

Section: Coagulase-positive Staphylococcimentioning

confidence: 99%

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Prevalence and antimicrobial resistance profile of pathogens isolated from patients with urine tract infections admitted to a university hospital in a medium-sized Brazilian city

Negri,

Lima,

Woloszynek

et al. 2024

Rev. Inst. Med. trop. S. Paulo

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This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher's exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gramnegative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

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Clinical and phylogenetic characteristics of Escherichia coli urinary tract infections

Cited by 3 publications

References 0 publications

UropathogenicEscherichia coliST131 in urinary tract infections in children

UropathogenicEscherichia coliST131 in urinary tract infections in children

Molecular typing of uropathogenicEscherichia coliisolated from Korean children with urinary tract infection

Prevalence and antimicrobial resistance profile of pathogens isolated from patients with urine tract infections admitted to a university hospital in a medium-sized Brazilian city

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