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P-fimbriated Escherichia coli in children with acute cystitis
K J Lidefelt1, I Bollgren, G Källenius
1Department of Paediatrics, Sachs' Children's Hospital, Stockholm, Sweden.
Insights
P-fimbriated Escherichia coli strains are common in children with cystitis. These bacteria may act as virulence factors in lower urinary tract infections, but P-fimbriation did not predict reinfection risk.
Area of Science:
- Pediatrics
- Microbiology
- Infectious Diseases
Background:
- P-fimbriation of Escherichia coli is a known virulence factor in pyelonephritis.
- Childhood urinary tract infections (UTIs) require further investigation into bacterial factors.
- Understanding E. coli virulence in lower UTIs is crucial for effective management.
Purpose of the Study:
- To investigate the clinical and bacteriological features of single, symptomatic, non-febrile UTIs (cystitis) in children.
- To determine the frequency of P-fimbriated E. coli in these infections.
- To assess the association between P-fimbriated E. coli and subsequent UTI reinfection.
Main Methods:
- Study included 75 children with symptomatic, non-febrile UTIs.
- Bacteriological analysis focused on identifying E. coli and its P-fimbriation status.
- Clinical data collected on initial infection and reinfection over six months.
Main Results:
- E. coli caused 88% of the UTIs.
- P-fimbriated E. coli strains were identified in 48% of E. coli infections.
- No correlation was found between P-fimbriated E. coli and the risk of reinfection.
Conclusions:
- P-fimbriated E. coli may be a significant virulence factor in pediatric cystitis.
- P-fimbriation of E. coli does not appear to predict recurrent UTIs in this cohort.
- Further research is needed to fully elucidate the role of P-fimbriated E. coli in lower UTIs.
Abstract:
P-fimbriation of Escherichia coli is an important factor in the pathogenesis of childhood pyelonephritis. The present study investigates children with single episodes of symptomatic non-febrile urinary tract infection, i.e. cystitis, with respect to clinical appearance and bacteriology, especially the frequency of P-fimbriated E. coli. The study included 75 children, 57 of whom had their first attack of urinary tract infection. E. coli was the causative agent in 88% (66/75) of the infections, and 48% (32/66) of E. coli strains were P-fimbriated. No association was found between identification of P-fimbriated E. coli at index infection and proneness to reinfection during the following six-month period. It is suggested that P-fimbriated E. coli is a virulence factor even in lower urinary tract infections, when occurring in single, symptomatic episodes.