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E. coli virulence factors in children with neurogenic bladder associated with bacteriuria

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Abstract

The value of E. coli virulence factors in patients with neurogenic bladder has not been established. The aim of this study is to correlate E. coli virulence factors with asymptomatic and symptomatic UTI in children with neurogenic bladder. Fifty E. coli strains, which were collected in sequence, underwent analysis in relation to: the association to pyuria, serotype (O:H), the presence of genes and expression of fimbriae P, type 1, S and hemagglutinin Dr, the presence of the gene and production of hemolysins and cytotoxins (CNF1). We also analyzed the cell adherence capability and pattern and presence of usp (uropathogenic-specific protein). Pyuria was present in most of the positive urine cultures, with 86% AB and 97% UTI. Low rates of uropathogenic strains were observed in the two groups, with 18% AB and 21% UTI. Type 1 fimbria predominated in 44% of the E. coli strains. Of the bacteria studied, 30% (15 strains) exhibited papG genotypes (11 class II and 4 class III). Of these, 12/15 patients presented AB. Production of hemolysins was detected in 38% of the strains (16 AB and 3 UTI) and usp in only 18% of the strains, with 8 AB and 1 UTI. Adherence tests demonstrated the adhesive capacity in all samples analyzed. Neither group (AB or symptomatic UTI) presented a statistically significant difference in relation to the virulence factors studied. E. coli clones that caused symptomatic UTI in children with neurogenic bladder expressed few virulence factors, with no statistically significant difference in comparison to the AB group.

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References

  1. Lapides J, Diokno AC, Silber SJ, Lowe BS (1972) Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol 107:458–461

    PubMed  Google Scholar 

  2. Joseph DB, Bauer SB, Colodny AH, Mandell J, Retik AB (1989) Clean, intermittent catheterization of infants with neurogenic bladder. Pediatrics 84:78–82

    PubMed  Google Scholar 

  3. Kass EJ, Koff SA, Diokno AC, Lapides J (1981) The significance of bacilluria in children on long-term intermittent catheterization. J Urol 126:223–225

    PubMed  Google Scholar 

  4. Schlager TA, Dilks S, Trudell J, Whittam TS, Hendley JO (1995) Bacteriuria in children with neurogenic bladder treated with intermittent catheterization: natural history. J Pediatr 126:490–496

    Article  PubMed  Google Scholar 

  5. Schlager TA, Whittam TS, Hendley JO, Wilson RA, Bhang J, Grady R, Stapleton A (2000) Expression of virulence factors among Escherichia coli isolated from the periurethra and urine of children with neurogenic bladder on intermittent catheterization. Pediatr Infect Dis J 19:37–41

    Article  PubMed  Google Scholar 

  6. Brem AS, Martin D, Callaghan J, Maynard J (1987) Long-term renal risk factors in children with meningomyelocele. J Pediatr 110:51–55

    PubMed  Google Scholar 

  7. Schlager TA, Dilks SA, Lohr JA, Hayden GF, Kopco JA, Hendley JW (1992) Periurethral colonization and urinary leukocytes as markers for bacteriuria in children with neurogenic bladder. Urol Res 20:361–363

    Article  PubMed  Google Scholar 

  8. Stöher M, Castro- Diaz D, Chartier-Kartler E (2003) Guidelines on neurogenic lower urinary tract dysfunction. European Association of Urology (cited 2003 Feb 2). Available from: http//www.uroweb.org/files/uploaded_files/guidelines/neurogenic.pdf

    Google Scholar 

  9. Hellerstein S (1982) Recurrent urinary tract infections in children. Pediatr Infect Dis 1:271–281

    PubMed  Google Scholar 

  10. Kass EH (1956) Asymptomatic infections of the urinary tract. Trans Assoc Am Physicians 69:56–64

    PubMed  Google Scholar 

  11. Blanco J, Blanco M, Alonso MP (1992) A Factores de virulência de los Escherichia coli causantes de infecciones extraintestinales. Monografias da Universidade de Compostela no 170:87–90

    Google Scholar 

  12. Evans, DJ Jr, Evans DG, Young LS, Pitt J (1981) Hemagglutination typing of Escherichia coli: definition of seven hemagglutination types. J Clin Microbiol 12:235–242

    Google Scholar 

  13. Gander RM, Thomas VL, Forland M (1985) Mannose-resistant hemagglutination and P receptor recognition of uropathogenic Escherichia coli isolated from adult patients. J Infect Dis 151:508–513

    PubMed  Google Scholar 

  14. Blanco J, Blanco M, Gonzalez EA, Alonso MP, Garabal JI (1990) Comparative evaluation of three tests for the detection of Escherichia coli cytotoxic necrotizing factors (CNF1 and CNF2) using filtrates of cultures treated with mitomycin C. FEMS Microbiol Lett 57:311–316

    Article  PubMed  Google Scholar 

  15. Scaletsky IC, Silva, ML, Trabulsi LR (1984) Distinctive patterns of adherence of enteropathogenic Escherichia coli to HeLa cells. Infect Immun 45:534–536

    PubMed  Google Scholar 

  16. Blanco M, Blanco JE, Rodrigues E (1997) Detection of virulence genes in uropathogenic Escherichia coli by polymerase chain reaction (PCR): comparison with results obtained using phenotypic methods. J Microbiol Methods 31:37–43

    Article  Google Scholar 

  17. Yamamoto S, Terai A, Yuri K, Kurazono H, Takeda Y, Yoshida O (1995) Detection of urovirulence factors in Escherichia coli by multiplex polymerase chain reaction. FEMS Immunol Med Microbiol 12:85–90

    Article  PubMed  Google Scholar 

  18. Daigle F, Harel J, Fairbrother JM, Lebel P (1994) Expression and detection of pap-, sfa-, and afa-encoded fimbrial adhesin systems among uropathogenic Escherichia coli. Can J Microbiol 40:286–291

    PubMed  Google Scholar 

  19. Pickett CL, Twiddy EM, Coker C, Holmes RK (1989) Cloning, nucleotide sequence, and hybridization studies of the type IIb heat-labile enterotoxin gene of Escherichia coli. J Bacteriol 171:4945–4952

    PubMed  Google Scholar 

  20. Karkkianen UM, Kauppinen J, Ikaheimo R (1998) A Rapid and specific detection of three different G adhesin classes of P-fimbriae in uropathogenic Escherichia coli by polimerase chain reaction. J Microl Method 34:23–29

    Article  Google Scholar 

  21. Kurazono H, Yamamoto S, Nakano M, Nair GB, Terai A, Chaicumpa W, Hayashi H (2000) Characterization of a putative virulence island in the chromosome of uropathogenic Escherichia coli possessing a gene encoding a uropathogenic-specific protein. Microb Pathog 28:183–189

    Article  PubMed  Google Scholar 

  22. Rosner B (1986) Fundamentals of biostatistics, 2nd edn. PWS Publishers, Boston

  23. Sotolongo JR Jr, Koleilat N (1990) Significance of asymptomatic bacteriuria in spinal cord injury patients on condom catheter. J Urol 143:979–980

    PubMed  Google Scholar 

  24. Andersson P, Engberg I, Lidin-Janson G, Lincoln K, Hull R, Hull S, Svanborg C (1991) Persistence of Escherichia coli bacteriuria is not determined by bacterial adherence. Infect Immun 59:2915–2921

    PubMed  Google Scholar 

  25. Gribble MJ, McCallum NM, Schechter MT (1988) Evaluation of diagnostic criteria for bacteriuria in acutely spinal cord injured patients undergoing intermittent catheterization. Diagn Microbiol Infect Dis 9:197–206

    Article  PubMed  Google Scholar 

  26. Schlager TA, Grady R, Mills SE, Hendley JO (2004) Bladder epithelium is abnormal in patients with neurogenic bladder due to myelomeningocele. Spinal Cord 42:163–168

    Article  PubMed  Google Scholar 

  27. Orskov F, Sharma V, Orskov I (1984) Influence of growth temperature on the development of Escherichia coli polysaccharide K antigens. J Gen Microbiol 130:2681–2684

    PubMed  Google Scholar 

  28. Hansson S, Jodal U, Lincoln K, Svanborg-Eden C (1989) Untreated asymptomatic bacteriuria in girls: II--Effect of phenoxymethylpenicillin and erythromycin given for intercurrent infections. BMJ 298:856–859

    PubMed  Google Scholar 

  29. Eisenstein BI (1981) Phase variation of Type 1 fimbriae in Escherichia coli is under transcriptional control. Science 214:337–339

    PubMed  Google Scholar 

  30. Miyazaki J, Ba-Thein W, Kumao T, Obata Yasuoka M, Akaza H, Hayshi H (2002) Type 1, P and S fimbriae, and afimbrial adhesin I are not essential for uropathogenic Escherichia coli to adhere to and invade bladder epithelial cells. FEMS Immunol Med Microbiol 33:23–26

    Article  PubMed  Google Scholar 

  31. Mobley HL, Chippendale GR, Tenney JH, Hull RA, Warren JW (1987) Expression of type 1 fimbriae may be required for persistence of Escherichia coli in the catheterized urinary tract. J Clin Microbiol 25:2253–2257

    PubMed  Google Scholar 

  32. Plos K, Connell H, Jodal U, Marklund BI, Marild S, Wettergren B, Svanborg C (1995) Intestinal carriage of P fimbriated Escherichia coli and the susceptibility to urinary tract infection in young children. J Infect Dis 171:625–631

    PubMed  Google Scholar 

  33. Puente JL, Finlay BB (2001) Pathogenic Escherichia coli. In: Groisman EA (ed) Principles of bacterial pathogenesis. Academic Press, San Diego, pp 387–457

  34. Roberts JA, Marklund BI, Ilver D, Haslam D, Kaack MB, Baskin G, Louis M, Mollby R, Winberg J, Normark S (1994) The Gal(alpha 1–4)Gal-specific tip adhesin of Escherichia coli P-fimbriae is needed for pyelonephritis to occur in the normal urinary tract. Proc Natl Acad Sci USA 91:11889–11893

    PubMed  Google Scholar 

  35. Tseng CC, Huang JJ, Ko WC, Yan JJ, Wu JJ (2001) Decreased predominance of papG class II allele in Escherichia coli strains isolated from adults with acute pyelonephritis and urinary tract abnormalities. J Urol 166:1643–1646

    Article  PubMed  Google Scholar 

  36. Andreu A, Stapleton AE, Fennell C, Lockman HA, Xercavins M, Fernandez F, Stamm WE (1997) Urovirulence determinants in Escherichia coli strains causing prostatitis. J Infect. Dis 176:464–469

    Google Scholar 

  37. Foxman B, Zhang L, Palin K, Tallman P, Marrs CF (1995) Bacterial virulence characteristics of Escherichia coli isolates from first-time urinary tract infection. J Infect Dis 171:1514–1521

    PubMed  Google Scholar 

  38. Nakano M, Yamamoto S, Terai A, Ogawa O, Makino SI, Hayashi H, Nair GB, Kurazono H (2001) Structural and sequence diversity of the pathogenicity island of uropathogenic Escherichia coli which encodes the USP protein. FEMS Microbiol Lett 205:71–76

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Maura A. L. Miranda and nurse Silvana de La Penha Chiacchio for technical assistance, and CAPES and CNPq for support of this research. We are grateful to the Support Center for Scientific Publications of Santa Casa de São Paulo, the Faculty of Medical Sciences, for the editorial assistance.

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Authors and Affiliations

  1. Department of Pediatrics Nephrology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil

    Eliana B. M. Guidoni, Vanessa A. Dalpra & Julio Toporovski

  2. Department of Microbiology, Santa Casa de São Paulo Faculty of Medical Sciences, São Paulo, Brazil

    Lycia Mara J. Mímica

  3. Department of Microbiology and Immunology, Biological Institute, Universidade Estadual de Campinas, Campinas, Brazil

    Patrícia Maria Figueiredo, Domingos da Silva Leite & Tomomasa Yano

  4. Reference Laboratory for E. coli (LREC), University of Santiago de Compostela Veterinary Faculty, 27002, Lugo, Spain

    Jesus E. Blanco

  5. , Av. Pacaembu 1083, CEP: 01234-001, São Paulo, Brazil

    Julio Toporovski

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  1. Eliana B. M. Guidoni
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  2. Vanessa A. Dalpra
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  3. Patrícia Maria Figueiredo
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  8. Julio Toporovski
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Correspondence to Julio Toporovski.

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Guidoni, E.B.M., Dalpra, V.A., Figueiredo, P.M. et al. E. coli virulence factors in children with neurogenic bladder associated with bacteriuria. Pediatr Nephrol 21, 376–381 (2006). https://doi.org/10.1007/s00467-005-2133-0

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  • DOI: https://doi.org/10.1007/s00467-005-2133-0

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