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Special virulence of the Escherichia coli O1:K1:H7 clone in acute pyelonephritis
Insights
Certain Escherichia coli strains with globo+ adhesion cause more severe inflammatory responses in children with acute pyelonephritis. The O1:K1:H7 clone shows enhanced virulence, leading to quicker, more acute infections.
Area of Science:
- Pediatric infectious diseases
- Microbial pathogenesis
- Immunology
Background:
- Acute pyelonephritis is a serious kidney infection in children.
- Bacterial virulence factors play a crucial role in disease severity.
- Understanding the interaction between bacterial properties and host response is key.
Purpose of the Study:
- To investigate the relationship between bacterial properties and acute-phase responses in children with acute pyelonephritis.
- To identify specific bacterial clones and their association with disease severity.
Main Methods:
- Studied 88 children with their first episode of acute pyelonephritis.
- Analyzed Escherichia coli strains for clonotypes (O:K:H stereotypes) and globotetraosylceramide-specific (globo+) adhesion.
- Correlated bacterial properties with clinical inflammatory markers.
Main Results:
- Globotetraosylceramide-specific (globo+) adhesion was more prevalent in multiply occurring E. coli clones (90%) compared to singly occurring ones (62%).
- Patients infected with globo+ strains exhibited significantly increased inflammatory reactions.
- The O1:K1:H7 clone, always expressing globo+ adhesins, was most frequent and associated with a shorter symptom duration, higher fever, and elevated leukocyte count.
Conclusions:
- Globotetraosylceramide-specific adhesion is linked to heightened inflammatory responses in pediatric pyelonephritis.
- The O1:K1:H7 E. coli clone demonstrates enhanced virulence, characterized by acute onset and severe clinical presentation.
- Bacterial clonotype and adhesin expression are critical determinants of acute pyelonephritis severity in children.
Abstract:
The relationship between acute-phase responses and bacterial properties was studied in a population of 88 children with their first known episode of acute pyelonephritis. One strain from each patient was included in the study. Eighty-four of the patients were infected with Escherichia coli, which was assigned a clonotype according to the O:K:H stereotype; 55 patients carried one of the 12 multiply occurring clones. Globotetraosylceramide-specific (globo+) adhesion was present in 90% of these 12 clones, compared with 62% in the remaining 29 singly occurring clones. The patients infected with globo+ strains had significantly increased inflammatory reactions compared with patients with globo- strains. The O1:K1:H7 strain was the single most frequent clone (n = 14) that always expressed globo+ adhesins. Patients infected with O1:K1:H7 had an inflammatory response similar to that of other globo+ infections, but had a shorter duration of symptoms before diagnosis, higher fever, and higher peripheral leukocyte count. These results demonstrate special virulence of the O1:K1:H7 clone, reflected by the acuteness of onset of infection.