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Host-parasite relationships in acute pyelonephritis
Abstract:
During a 1-year prospective study, a total of 15 patients (seven children and eight adults) were observed with acute nonobstructive pyelonephritis. P-fimbriated Escherichia coli was the causative pathogen in all 15 patients. The same serotype of E coli that was P-fimbriated was isolated from the vaginal introitus of 60% and from the fecal flora of 86% of these patients. The only host abnormality was moderate vesicoureteral reflux in 20% of the patients. Uroepithelial cells were isolated from the first morning-voided urine from patients, who had recovered from pyelonephritis, and from age-matched controls. Using fluorescein-labelled type 1 and P-fimbriated reference strains of E coli and fluorescence-activated cell sorting (FACS) analysis, we evaluated their ability to adhere to these uroepithelial cells. P-fimbriated E coli was more adherent than type 1 fimbriated E coli, and more P-fimbriated E coli adhered to the patients' cells. Our data show that both colonization with P-fimbriated strains of E coli and receptor availability are important in the pathogenesis of pyelonephritis.
Insights
P-fimbriated Escherichia coli causes pyelonephritis by adhering to uroepithelial cells. Both bacterial colonization and host cell receptor availability are crucial for this kidney infection.
Area of Science:
- Urology
- Microbiology
- Infectious Diseases
Background:
- Acute pyelonephritis is a kidney infection.
- Escherichia coli is a common cause of urinary tract infections.
Purpose of the Study:
- To investigate the role of P-fimbriated E. coli in acute pyelonephritis.
- To compare the adherence of P-fimbriated and type 1 fimbriated E. coli to uroepithelial cells.
Main Methods:
- Prospective study of 15 patients with acute pyelonephritis.
- Isolation and serotyping of E. coli from patients.
- Fluorescence-activated cell sorting (FACS) analysis to assess bacterial adherence to uroepithelial cells.
Main Results:
- P-fimbriated E. coli was the causative agent in all patients.
- P-fimbriated E. coli showed higher adherence to uroepithelial cells compared to type 1 fimbriated E. coli.
- Increased adherence of P-fimbriated E. coli was observed to uroepithelial cells from patients.
Conclusions:
- Colonization with P-fimbriated E. coli is important in pyelonephritis pathogenesis.
- Host uroepithelial cell receptor availability plays a significant role in E. coli adherence and infection.