Host-Pathogen Relationships among Escherichia coli Isolates Recovered from Men with Febrile Urinary Tract Infection

Background. Host-pathogen relationships in men with febrile urinary tract infection (FUTI) are poorly understood. Methods. Phylogenetic background, extended virulence genotypes, and serotypes were determined for 70 Escherichia coli isolates recovered from urine samples obtained from men with FUTI fo...

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Published in:	Clinical infectious diseases 2005-03, Vol.40 (6), p.813-822
Main Authors:	Johnson, James R., Scheutz, Flemming, Ulleryd, Peter, Kuskowski, Michael A., O'Bryan, Timothy T., Sandberg, Torsten
Format:	Article
Language:	eng
Subjects:	acute bacterial prostatitis acute pyelonephritis Adolescent Adult Aged Aged, 80 and over Aging Alleles Antigens Arbetslivsstudier bacteremia Bacteria Bacterial diseases Bacterial diseases of the urinary system Bacterial sepsis Biological and medical sciences compromise Escherichia coli Escherichia coli - genetics Escherichia coli - isolation & purification Escherichia coli - metabolism Escherichia coli Infections - microbiology Escherichia coli Infections - urine Excretory system Fever Fimbriae Host-Parasite Interactions Human bacterial diseases Humans Immunologi inom det medicinska området Immunology in the medical area Infections Infectious diseases Infectious Medicine Infektionsmedicin Major Articles Male Medical disorders Medical sciences Men Microbiology in the medical area Middle Aged Mikrobiologi inom det medicinska området Nephrology. Urinary tract diseases papa alleles Phylogenetics Phylogeny prostate-specific antigen Prostatitis Rectum - microbiology Risk Factors Serotyping strains Urinary system involvement in other diseases. Miscellaneous Urinary tract infections Urinary Tract Infections - microbiology Urinary Tract Infections - urine Urinary tract. Prostate gland Urine urosepsis Virulence Virulence factors Virulence Factors - genetics Virulence Factors - metabolism women Work Sciences
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Summary:	Background. Host-pathogen relationships in men with febrile urinary tract infection (FUTI) are poorly understood. Methods. Phylogenetic background, extended virulence genotypes, and serotypes were determined for 70 Escherichia coli isolates recovered from urine samples obtained from men with FUTI for comparison with available data for 70 E. coli rectal isolates recovered from uninfected men. Bacterial traits were assessed in relation to underlying host characteristics (age, compromise status, and history of urinary tract infection) and acute manifestations (bacteremia, flank pain, and serum prostate-specific antigen [PSA] level). Results. Compared with rectal isolates, FUTI isolates exhibited a significantly higher prevalence of virulence-associated phylogenetic groups, serotypes, and extraintestinal virulence genes. The latter included traditional prostatitis-associated traits (e.g., hemolysin and cytotoxic necrotizing factor), as well as unconventional traits, such as outer membrane protease T. These bacterial traits occurred largely independent of host age, urological compromise status, urinary tract infection history, and acute manifestations. However, certain traits were less prevalent in association with use of urinary tract instrumentation and significantly predicted elevated PSA levels. Conclusions. Considerable virulence capability may be required for an E. coli strain to cause FUTI in men, regardless of whether most compromising conditions are present. Bacterial traits that promote prostatic invasion may be relevant for the pathogenesis of FUTI, even among men without classic manifestations of acute prostatitis.
ISSN:	1058-4838 1537-6591