E. coli virulence factors in children with neurogenic bladder associated with bacteriuria

Abstract

The value of E. coli virulence factors in patients with neurogenic bladder has not been established. The aim of this study is to correlate E. coli virulence factors with asymptomatic and symptomatic UTI in children with neurogenic bladder. Fifty E. coli strains, which were collected in sequence, underwent analysis in relation to: the association to pyuria, serotype (O:H), the presence of genes and expression of fimbriae P, type 1, S and hemagglutinin Dr, the presence of the gene and production of hemolysins and cytotoxins (CNF1). We also analyzed the cell adherence capability and pattern and presence of usp (uropathogenic-specific protein). Pyuria was present in most of the positive urine cultures, with 86% AB and 97% UTI. Low rates of uropathogenic strains were observed in the two groups, with 18% AB and 21% UTI. Type 1 fimbria predominated in 44% of the E. coli strains. Of the bacteria studied, 30% (15 strains) exhibited papG genotypes (11 class II and 4 class III). Of these, 12/15 patients presented AB. Production of hemolysins was detected in 38% of the strains (16 AB and 3 UTI) and usp in only 18% of the strains, with 8 AB and 1 UTI. Adherence tests demonstrated the adhesive capacity in all samples analyzed. Neither group (AB or symptomatic UTI) presented a statistically significant difference in relation to the virulence factors studied. E. coli clones that caused symptomatic UTI in children with neurogenic bladder expressed few virulence factors, with no statistically significant difference in comparison to the AB group.

Escherichia coli Isolates Causing Asymptomatic Bacteriuria in Catheterized and Noncatheterized Individuals Possess Similar Virulence Properties

“…The catheter literature has also been complicated by the lack of differentiation between bacterial isolates causing CA-ABU and catheterassociated symptomatic urinary tract infection (CAUTI), with guidelines recently being published to rectify this (13,40). Comparative studies have been carried out mainly with patients with bladder dysfunction and intermittent catheterization where there were limited or no differences between the E. coli strains causing asymptomatic and symptomatic infections (8,15). Since the insertion and presence of an indwelling catheter substantially change the urinary tract environment, we compared the virulence properties of E. coli isolates causing asymptomatic bacteriuria in catheterized and noncatheterized patients.…”

The Role of Host Factors and Bacterial Virulence Genes in the Development of Pyelonephritis Caused by Escherichia coli in Renal Transplant Recipients

“…According to Tseng et al (11), P-fimbria virulence factors have been suggested to be less common under immunosuppression, although the exact distribution of papGII among isolates of PN from immunosuppressed patients was not specified (11). Some investigators observed a lower predominance of papGII in E. coli isolated from UTI patients with urinary abnormalities, either in children (44,45) or in adults (46). Although patients with neurogenic bladder were excluded from the sample presented here, UTI occurring in a transplanted patient is already considered as a complicated one (47) because of the heterotopic position of the graft and the shorter ureteral length.…”

Population Phylogenomics of Extraintestinal PathogenicEscherichia coli

“…Bacteriuria is a very common complication in these last two patient groups. E. coli strains isolated from symptomatic and nonsymptomatic bacteriuria in neurogenic-bladder patients express the same adhesion molecules (115)(116)(117). Patients with neurogenic bladder most frequently need intermittent or long-term bladder catheterization.…”