Pediatr Infect Vaccine.  2015 Dec;22(3):194-200. 10.14776/piv.2015.22.3.194.

Phylogenetic Groups and Virulence Factors of Escherichia coli Causing Urinary Tract Infection in Children

• Kim JM
• Cho EY
• Lee JH

• KMID: 2315685
• DOI: http://doi.org/10.14776/piv.2015.22.3.194

Abstract

PURPOSE
Urinary tract infection (UTI) is a common bacterial infection in children and Escherichia coli is a predominant pathogen. The purpose of this study is to evaluate phylogenetic groups and virulence factors of E. coli causing UTI in children in Korea.
METHODS
From October 2010 to April 2013, urinary E. coli strains were isolated from the 33 pediatric patients of UTI. Multiplex polymerase chain reactions were performed to evaluate the phylogenetic groups and 5 virulence factor genes (fimH, sfa, papA, hylA, and cnf1) of E. coli. Distribution of molecular characteristics of E. coli was analyzed by clinical diagnosis and accompanying vesicoureteral reflux (VUR).
RESULTS
Most (84.8%) uropathogenic E. coli were belonged to phylogenetics group B2 and the others (15.2%) were belonged to group D. The virulence factors were distributed as: fimH (100%), sfa (100%), hylA (63.6%), cnfI (63.6%), and papA (36.4%). According to clinical diagnosis, phylogenetic distribution of E. coli strain was 92.3% of B2 and 7.7% of D in acute pyelonephritis and 57.1% of B2 and 42.9% of D in cystitis. Distribution of virulence factors was similar in both groups. In patients with acute pyelonephritis, phylogenetic distribution was similar in VUR and non-VUR group, but proportion of papA genes were lower in VUR group than that of non-VUR group (43.8% vs. 20.0%, P=0.399).
CONCLUSIONS
This study provides current epidemiologic molecular data of E. coli causing pediatric UTI in Korea and will be a fundamental for understanding the pathogenesis of pediatric UTI.

Keyword

Escherichia coli; Virulence factor; Phylogenetic groups; Acute pyelonephritis

MeSH Terms

Bacterial Infections
Child*
Cystitis
Diagnosis
Escherichia coli*
Escherichia*
Humans
Korea
Polymerase Chain Reaction
Pyelonephritis
Urinary Tract Infections*
Urinary Tract*
Vesico-Ureteral Reflux
Virulence Factors*
Virulence*
Virulence Factors

Reference

1. Shaikh N, Morone NE, Bost IE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J. 2008; 27:302–8.

2. Roberts KB, Akintemi OB. The epidemiology and clinical presentation of urinary tract infections in children younger than 2 years of age. Pediatr Ann. 1999; 28:644–9.

3. Faust WC, Diaz M, Pohl HG. Incidence of post-pyeloneph-ritic renal scarring: a meta-analysis of the dimercapto-succinic acid literature. JUrol. 2009; 181:290–8.

4. Park YS. Renal scar formation after urinary tract infection in children. Korean JPediatr. 2012; 55:367–70.

5. Lee Y]. Lee JH, Park YS. Risk factors for renal scar formation in infants with first episode of acute pyelonephritis: a pro-spective clinical study. JUrol. 2012; 187:1032–6.

6. Pecile P, Miorin E, Romanello C, Vidal E, Contardo M, Valent F, et al. Age-related renal parenchymal lesions in children with first febrile urinary tract infections. Pediatrics. 2009; 124:23–9.

7. Jung HJ, Aum JA, Jung SJ, Huh JW. Different characteristic between Eschericbea coli and non-Escberjcbea 6011' urinary tract infection. Korean I Pediatr. 2007; 50:457–61.

8. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002; 113:5–13.

9. Bien J, Sokolova O, Bozko P. Role of uropathogenic Escherichia coli Virulence factors in development of urinary tract infection and kidney damage. Int J Nephrol 20122012681473.

10. Bonacorsi S, Houdouin V, Mariani-Kurkdjian P, Mahjoub-Messai F, Bingen E. Comparative prevalence of Virulence factors in Escherichia coli causing urinary tract infection in male infants with and without bacteremia. I Clin Microbiol. 2006; 44:1156–8.

11. Lee DG, Cho JJ, Park HK, Kim DK, Kim II, Chang SG, et al. Preventive effects of hyaluronic acid on Escherichia coli-in— duced urinary tract infection in rat. Urology. 2010; 75:949–54.

12. Chiou YY, Chen M], Chiu NT, Lin CY, Tseng CC. Bacterial Virulence factors are associated With occurrence of acute pyelonephritis but not renal scarring. J Urol. 2010; 184:2098–102.

13. Billips BK, Forrestal SG, Rycyk MT, Johnson IR, Klumpp DI, Schaeffer A}. Modulation of host innate immune response in the bladder by uropathogenic Escherichia coli. Infect Immun. 2007; 75:5353–60.

14. Schilling ID, Mulvey MA, Hultgren S]. Dynamic interactions between host and pathogen during acute urinary tract infec—tions. Urology. 2001; 57:56–61.

15. Song I, Abraham S. Innate and adaptive immune responses in the urinary tract. Eur I Clin Invest. 2008; 38:21–8.

16. Clermont O, Bonacorsi S, Bingen E. Rapid and simple deter—mination of the Escherichia coli phylogenetic group. Appl Environ Microbiol. 2000; 66:4555–8.

17. Tarchouna M, Ferjani A, Ben-Selma W, Boukadida I. Distribution of uropathogenic Virulence genes in Escherichia coli isolated from patients with urinary tract infection. Int I Infect Dis. 2013; 17:6450–3.

18. Newman TB, Bernzweig IA, Takayama II, Finch SA, Was-serman RC, Pantell RH. Urine testing and urinary tract infections in febrile infants seen in office settings: the Pediatric Research in Office Settings' Febrile Infant Study. Arch Pediatr Adolesc Med. 2002; 156:44–54.

19. Mak RH, Kuo H]. Pathogenesis of urinary tract infection: an update. Curr Opin Pediatr. 2006; 18:148–52.

20. Johnson IR, Owens K, Gajewski A, Kuskowski MA. Bacterial characteristics in relation to clinical source of Escherichia coli isolates from women with acute cystitis or pyelonephritis and uninfected women. I Clin Microbiol. 2005; 43:6064–72.

21. Tiba MR, Yano T, Leite Dda S. Genotypic characterization of virulence factors in Escherichia 6011' strains from patients with cystitis. Rev Inst Med Trop Sao Paulo. 2008; 50:255–60.

22. Houdouin V, Bonacorsi S, Mahjoub-Messai F, Mariani—Kurkdjian P, Bidet P, Sebag G, et al. Phylogenetic groups and Virulence factors of Escherichia coli strains causing pyelonephritis in children with and without urinary tract abnormalities. Clin Microbiol Infect. 2007; 13:740–2.

23. Brauner A, Jacobson SH, Kuhn I. Urinary Escherichia coli causing recurrent infections-a prospective follow-up of biochemical phenotypes. Clin Nephrol. 1992; 38:318–23.

24. Foxman B, Gillespie B, Koopman J, Zhang L, Palin K, Tallman P, et al. Risk factors for second urinary tract infection among college women. Am I Epidemiol. 2000; 151:1194–205.

25. Ik'alhelmo R, Siitonen A, Heiskanen T, Kérkkéiinen U, Kuos-manen P, Lipponen P, et al. Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women. Clin Infect Dis. 1996; 22:91–9.