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Escherichia coli Strains Responsible for Cystitis in Female Pediatric Patients with Normal and Abnormal Urinary
Marta de Oliveira Domingos1, Silvio Marciano da Silva Junior1, Wagner Milanello2
1Laboratório de Bacteriologia, Instituto Butantan, Avenida Vital Brasil, 1500, São Paulo 05503-900, SP, Brazil.
Insights
Uropathogenic Escherichia coli (UPEC) strains differ in female patients with normal versus abnormal urinary tracts. Cystitis in normal tracts links to ExPEC, while abnormal tracts associate with intestinal E. coli strains adapted for bladder colonization.
Area of Science:
- Microbiology
- Urology
- Genetics
Background:
- Uropathogenic Escherichia coli (UPEC) is a significant cause of urinary tract infections (UTIs).
- The role of UPEC in female patients with urinary system abnormalities remains unclear.
- Understanding UPEC strain characteristics in relation to urinary tract anatomy is crucial for effective treatment.
Purpose of the Study:
- To determine the phenotype, genotype, and phylogeny of UPEC strains from pediatric female patients with cystitis.
- To compare UPEC strains isolated from patients with normal urinary tracts (NUT) versus abnormal urinary tracts (AUT).
- To elucidate the pathogenic mechanisms associated with UPEC in different urinary tract conditions.
Main Methods:
- Isolation and characterization of UPEC strains from urine samples.
- Multiplex PCR for phylogenetic grouping (phylo-groups B2 and D).
- Assessment of biofilm formation, adherence to epithelial cells, and detection of virulence genes (pap, sfa, hemolysin).
Main Results:
- UPEC strains from NUT patients predominantly belonged to phylo-groups B2 and D (86%).
- Isolates from AUT patients showed increased biofilm production, adherence, and presence of pap and sfa genes.
- Hemolysin-producing strains and UPEC-associated serogroups were more prevalent in NUT patients.
Conclusions:
- Cystitis in female patients with NUT is associated with Extra-intestinal pathogenic E. coli (ExPEC).
- Cystitis in female patients with AUT is linked to intestinal E. coli strains adapted for bladder colonization.
- Urinary tract abnormalities influence the type of pathogenic E. coli causing cystitis.
Abstract:
The role of uropathogenic Escherichia coli (UPEC) in colonization and infection of female patients with anatomical and functional abnormalities of the urinary system is elusive. In this study, the phenotype, genotype and the phylogeny of UPEC strains isolated from the urine of pediatric female patients with cystitis of normal and abnormal urinary tract were determined. Multiplex PCR results demonstrated that 86% of the strains isolated from female patients with normal urinary tract (NUT), belonged to the phylo-groups B2 and D. Their prevalence decreased to 23% in strains isolated from patients with abnormal urinary tract (AUT). More of the isolates from AUT patients produced a biofilm on polystyrene and polyvinyl chloride (PVC), adhered to epithelial cells, and encoded pap and sfa genes than strains isolated from female patients with NUT. In contrast, a higher number of hemolysin-producing strains with serogroups associated with UPEC were isolated from patients with NUT. In summary, the results suggest that cystitis in female patients with NUT is associated with ExPEC, whereas cystitis in female patients with AUT is associated with pathogenic intestinal E. coli strains that have acquired the ability to colonize the bladder.
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