Clonal relationships and extended virulence genotypes among Escherichia coli isolates from women with a first or recurrent episode of cystitis

被引:66
作者
Johnson, JR
O'Bryan, TT
Delavari, P
Kuskowski, M
Stapleton, A
Carlino, U
Russo, TA
机构
[1] Univ Minnesota, Dept Med, Minneapolis, MN 55455 USA
[2] Univ Minnesota, Dept Psychiat, Minneapolis, MN 55455 USA
[3] Vet Affairs Med Ctr, Med Serv, Minneapolis, MN 55417 USA
[4] Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Minneapolis, MN 55417 USA
[5] Univ Washington, Dept Med, Seattle, WA USA
[6] Vet Affairs Med Ctr, Med Serv, Buffalo, NY USA
[7] SUNY Buffalo, Dept Med, Buffalo, NY 14260 USA
[8] SUNY Buffalo, Ctr Microbial Pathogenesis, Buffalo, NY 14260 USA
关键词
D O I
10.1086/320198
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
To identify bacterial predictors of recurrence and/or persistence in acute cystitis, extended virulence genotypes were compared with clonal background and epidemiologic status among 74 Escherichia coli urine isolates from women with first or recurrent episodes of urinary tract infection (UTI). Sequential isolates from patients with recurrent UTI were classified, using macrorestriction analysis, as having caused an isolated recurrence versus a single or multiple same-strain recurrences. papA, papG allele II, iha, and iutA predicted multiple same-strain recurrences, whereas nfaE and the absence of sfaS or fyuA predicted isolated recurrences. Phylogenetic group B2 accounted for 70% of isolates and for most of the putative virulence factors (VFs) studied. The meningitis-associated O18: K1:H7 clonal group comprised 18% of isolates, exhibited multiple VFs, and caused "once-only" recurrences less commonly than did other strains. These findings identify specific VFs and clonal groups against which preventive interventions might be beneficial and illustrate the importance of delineating pathogenetically relevant subgroups within the "recurrent cystitis" population.
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页码:1508 / 1517
页数:10
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