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Role of K1 capsule antigen in cirrhotic patients with Escherichia coli spontaneous bacterial peritonitis in southern Taiwan

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Abstract

Spontaneous bacterial peritonitis (SBP) is one of the most serious complications in patients with cirrhosis. This study aimed to investigate the prevalence of SBP caused by Escherichia coli isolates with or without the K1 capsule antigen in cirrhotic patients and the outcome. From January 2004 to January 2012, a total of 54 and 41 E. coli strains derived from patients with SBP and intestinal perforation (IP), respectively, were included for comparison in this study. Bacterial characteristics including phylogenetic groups, K1 capsule antigen, and 14 virulence factor genetic determinants, as well as data regarding patient characteristics, clinical manifestations, and in-hospital deaths, were collected and analyzed. The prevalence of the K1 capsule antigen gene neuA was more common in SBP isolates compared to IP isolates (28 % vs. 10 %, p = 0.0385). Phylogenetic groups B2 and group D were dominant in E. coli isolates with and without the K1 capsule antigen, respectively. The prevalence of virulence factors genes papG II, ompT, and usp was higher in E. coli K1 strains. There were 26 deaths (48 %) during hospitalization. Presence of the K1 capsule antigen in E. coli isolates was significantly associated with in-hospital death in cirrhotic patients with SBP (42 % vs. 14 %, p = 0.0331). This study demonstrates a higher prevalence of the K1 capsule antigen in E. coli SBP compared to E. coli peritonitis caused by IP. There were significant associations between the K1 capsule antigen and in-hospital mortality and bacterial virulence in cirrhotic patients with E. coli SBP.

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References

  1. Lata J, Stiburek O, Kopacova M (2009) Spontaneous bacterial peritonitis: a severe complication of liver cirrhosis. World J Gastroenterol 15(44):5505–5510

    Article  PubMed  CAS  Google Scholar 

  2. Cheong HS, Kang CI, Lee JA, Moon SY, Joung MK, Chung DR, Koh KC, Lee NY, Song JH, Peck KR (2009) Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis. Clin Infect Dis 48(9):1230–1236

    Article  PubMed  Google Scholar 

  3. Lee JM, Han KH, Ahn SH (2009) Ascites and spontaneous bacterial peritonitis: an Asian perspective. J Gastroenterol Hepatol 24(9):1494–1503

    Article  PubMed  Google Scholar 

  4. Căruntu FA, Benea L (2006) Spontaneous bacterial peritonitis: pathogenesis, diagnosis, treatment. J Gastrointest Liver Dis 15(1):51–56

    Google Scholar 

  5. Bert F, Johnson JR, Ouattara B, Leflon-Guibout V, Johnston B, Marcon E, Valla D, Moreau R, Nicolas-Chanoine MH (2010) Genetic diversity and virulence profiles of Escherichia coli isolates causing spontaneous bacterial peritonitis and bacteremia in patients with cirrhosis. J Clin Microbiol 48:2709–2714

    Article  PubMed  CAS  Google Scholar 

  6. Bert F, Panhard X, Johnson J, Lecuyer H, Moreau R, Le Grand J, Johnston B, Sinègre M, Valla D, Nicolas-Chanoine MH (2008) Genetic background of Escherichia coli isolates from patients with spontaneous bacterial peritonitis: relationship with host factors and prognosis. Clin Microbiol Infect 14(11):1034–1040

    Article  PubMed  CAS  Google Scholar 

  7. Song KH, Jeon JH, Park WB, Park SW, Kim HB, Oh MD, Lee HS, Kim NJ, Choe KW (2009) Clinical outcomes of spontaneous bacterial peritonitis due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species: a retrospective matched case–control study. BMC Infect Dis 9:41

    Article  PubMed  Google Scholar 

  8. Wilson JW, Schurr MJ, LeBlanc CL, Ramamurthy R, Buchanan KL, Nickerson CA (2002) Mechanisms of bacterial pathogenicity. Postgrad Med J 78(918):216–224

    Article  PubMed  CAS  Google Scholar 

  9. Scholl D, Adhya S, Merril C (2005) Escherichia coli K1’s capsule is a barrier to bacteriophage T7. Appl Environ Microbiol 71(8):4872–4874

    Article  PubMed  CAS  Google Scholar 

  10. Kim KS, Itabashi H, Gemski P, Sadoff J, Warren RL, Cross AS (1992) The K1 capsule is the critical determinant in the development of Escherichia coli meningitis in the rat. J Clin Invest 90(3):897–905

    Article  PubMed  CAS  Google Scholar 

  11. Johnson JR, Oswald E, O’Bryan TT, Kuskowski MA, Spanjaard L (2002) Phylogenetic distribution of virulence-associated genes among Escherichia coli isolates associated with neonatal bacterial meningitis in the Netherlands. J Infect Dis 185(6):774–784

    Article  PubMed  CAS  Google Scholar 

  12. Bonacorsi S, Houdouin V, Mariani-Kurkdjian P, Mahjoub-Messai F, Bingen E (2006) Comparative prevalence of virulence factors in Escherichia coli causing urinary tract infection in male infants with and without bacteremia. J Clin Microbiol 44(3):1156–1158

    Article  PubMed  Google Scholar 

  13. Soriano G, Coll P, Guarner C, Such J, Sánchez F, Prats G, Vilardell F (1995) Escherichia coli capsular polysaccharide and spontaneous bacterial peritonitis in cirrhosis. Hepatology 21(3):668–673

    Article  PubMed  CAS  Google Scholar 

  14. Rimola A, García-Tsao G, Navasa M, Piddock LJ, Planas R, Bernard B, Inadomi JM (2000) Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club. J Hepatol 32(1):142–153

    Article  PubMed  CAS  Google Scholar 

  15. Durand F, Valla D (2005) Assessment of the prognosis of cirrhosis: Child–Pugh versus MELD. J Hepatol 42(Suppl 1):S100–S107

    Article  PubMed  Google Scholar 

  16. Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D’Amico G, Dickson ER, Kim WR (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33(2):464–470

    Article  PubMed  CAS  Google Scholar 

  17. Clinical and Laboratory Standards Institute (2011) Performance standards for antimicrobial susceptibility testing; twenty-first informational supplement. CLSI document M100-S21. CLSI, Wayne

    Google Scholar 

  18. Ferraro MJ, Gilligan PH, Saubolle MA, Weissfeld AS (1995) Bacteriology. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds) Manual of clinical microbiology, 6th edn. ASM Press, Washington, DC, pp 246–262

    Google Scholar 

  19. Wang MC, Tseng CC, Wu AB, Huang JJ, Sheu BS, Wu JJ (2009) Different roles of host and bacterial factors in Escherichia coli extra-intestinal infections. Clin Microbiol Infect 15(4):372–379

    Article  PubMed  Google Scholar 

  20. Tseng CC, Wu JJ, Liu HL, Sung JM, Huang JJ (2002) Roles of host and bacterial virulence factors in the development of upper urinary tract infection caused by Escherichia coli. Am J Kidney Dis 39(4):744–752

    Article  PubMed  Google Scholar 

  21. Robbins JB, McCracken GH Jr, Gotschlich EC, Orskov F, Orskov I, Hanson LA (1974) Escherichia coli K1 capsular polysaccharide associated with neonatal meningitis. N Engl J Med 290(22):1216–1220

    Article  PubMed  CAS  Google Scholar 

  22. McCracken GH Jr, Sarff LD, Glode MP, Mize SG, Schiffer MS, Robbins JB, Gotschlich EC, Orskov I, Orskov F (1974) Relation between Escherichia coli K1 capsular polysaccharide antigen and clinical outcome in neonatal meningitis. Lancet 2(7875):246–250

    Article  PubMed  Google Scholar 

  23. Pitt J (1979) Virulence of Escherichia coli K1 in adults. J Infect Dis 139(1):106–108

    Article  PubMed  CAS  Google Scholar 

  24. Marklund BI, Tennent JM, Garcia E, Hamers A, Båga M, Lindberg F, Gaastra W, Normark S (1992) Horizontal gene transfer of the Escherichia coli pap and prs pili operons as a mechanism for the development of tissue-specific adhesive properties. Mol Microbiol 6(16):2225–2242

    Article  PubMed  CAS  Google Scholar 

  25. Jauréguy F, Carbonnelle E, Bonacorsi S, Clec’h C, Casassus P, Bingen E, Picard B, Nassif X, Lortholary O (2007) Host and bacterial determinants of initial severity and outcome of Escherichia coli sepsis. Clin Microbiol Infect 13(9):854–862

    Article  PubMed  Google Scholar 

  26. Hui CY, Guo Y, He QS, Peng L, Wu SC, Cao H, Huang SH (2010) Escherichia coli outer membrane protease OmpT confers resistance to urinary cationic peptides. Microbiol Immunol 54(8):452–459

    Article  PubMed  CAS  Google Scholar 

  27. Stumpe S, Schmid R, Stephens DL, Georgiou G, Bakker EP (1998) Identification of OmpT as the protease that hydrolyzes the antimicrobial peptide protamine before it enters growing cells of Escherichia coli. J Bacteriol 180(15):4002–4006

    PubMed  CAS  Google Scholar 

  28. Kanamaru S, Kurazono H, Ishitoya S, Terai A, Habuchi T, Nakano M, Ogawa O, Yamamoto S (2003) Distribution and genetic association of putative uropathogenic virulence factors iroN, iha, kpsMT, ompT and usp in Escherichia coli isolated from urinary tract infections in Japan. J Urol 170(6 Pt 1):2490–2493

    Article  PubMed  Google Scholar 

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Funding

This work was supported by grants from the National Science Council (NSC 99-2314-B-006-017-MY3) and the Multidisciplinary Center of Excellence for Clinical Trial and Research, Department of Health, Executive Yuan, Taiwan (DOH101-TD-B-111-0022).

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No conflict of interest declared.

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Authors and Affiliations

  1. Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    M. C. Wang, W. H. Lin, C. C. Tseng & A. B. Wu

  2. Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    M. C. Wang

  3. Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    W. H. Lin

  4. Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    C. H. Teng

  5. Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    J. J. Yan

  6. Department of Medical Laboratory Science and Biotechnology, Infectious Disease and Signaling Research Center, College of Medicine, National Cheng Kung University, No. 1 University Road, 70101, Tainan, Taiwan

    J. J. Wu

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  1. M. C. Wang
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  2. W. H. Lin
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  3. C. C. Tseng
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  7. J. J. Wu
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Correspondence to J. J. Wu.

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Wang, M.C., Lin, W.H., Tseng, C.C. et al. Role of K1 capsule antigen in cirrhotic patients with Escherichia coli spontaneous bacterial peritonitis in southern Taiwan. Eur J Clin Microbiol Infect Dis 32, 407–412 (2013). https://doi.org/10.1007/s10096-012-1757-9

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  • DOI: https://doi.org/10.1007/s10096-012-1757-9

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