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Virulence factors of Escherichia coli isolated from urine of diabetic women with asymptomatic bacteriuria: correlation with clinical characteristics

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Abstract

Since Escherichia coli isolated from compromised patients with symptomatic urinary tract infections (UTIs) express fewer virulence factors than those isolated from healthy controls, the question arises whether this is also the case for diabetic patients with asymptomatic bacteriuria (ASB). Polymerase chain reaction (PCR) assays were conducted on 111E. coli strains, isolated from the urine of diabetic women with ASB, using primers for the major subunit A and the G-adhesin (I, II, and III) of P fimbriae, type 1 fimbriae, S fimbriae, afimbrial adhesin, cytotoxic necrotizing factor (CNF), and aerobactin. Phenotypically, hemolysis, mannose-sensitive hemagglutination, mannose-resistant hemagglutination and O:K:H-serotypes were determined. Furthermore, we investigated the associations between virulence factors and patient characteristics (including deterioration of renal function). Type 1 fimbriae were the most prevalent virulence factor (86% by genotyping and 59% phenotypically). Except for a lower prevalence of known uropathogenic O-serotypes, we found the same number of virulence factors in our compromised patient group as listed in the literature in noncompromised patients with ASB. Certain virulence factors (type 1 and S fimbriae and CNF) of the causative E. colicorrelated with the risk of a decline in renal function. In conclusion, the number of virulence factors in E. coli isolated from the urine of diabetic women with ASB are comparable with the results found in other (noncompromised) patients with ASB. Furthermore, certain virulence factors of E. colimight contribute to a decline in renal function.

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Authors and Affiliations

  1. Department of Medicine, Division Infectious Diseases & AIDS, University Medical Center Utrecht, The Netherlands

    Suzanne E. Geerlings & Andy I.M. Hoepelman

  2. Eijkman-Winkler Laboratory for Medical Microbiology, University Medical Center Utrecht, The Netherlands

    Ellen C. Brouwer & Andy I.M. Hoepelman

  3. Department of Bacteriology, Institute of Infectious Diseases and Immunology, Veterinary Faculty, Utrecht University, The Netherlands

    Wim Gaastra

  4. Julius Center for Patient Oriented Research, University Medical Center Utrecht, The Netherlands

    Ronald Stolk

  5. Laboratory for Medical Microbiology, Diakonessenhuis, Utrecht, The Netherlands

    Rob J.A. Diepersloot

Authors
  1. Suzanne E. Geerlings
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  2. Ellen C. Brouwer
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  3. Wim Gaastra
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  4. Ronald Stolk
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  5. Rob J.A. Diepersloot
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  6. Andy I.M. Hoepelman
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Geerlings, S.E., Brouwer, E.C., Gaastra, W. et al. Virulence factors of Escherichia coli isolated from urine of diabetic women with asymptomatic bacteriuria: correlation with clinical characteristics. Antonie Van Leeuwenhoek 80, 119–127 (2001). https://doi.org/10.1023/A:1012263304999

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