A prospective, longitudinal study of the behavior of serologically classified isolates of Escherichia coli in women with recurrent urinary tract infections

• Published in: The Journal of infection Vol. 55; no. 1; pp. 8 - 18
• Main Author: Vosti, Kenneth L
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-07-2007; Elsevier
• Subjects: Adolescent; Adult; Aged; Bacterial diseases; Bacterial diseases of the urinary system; Bacteriuria - epidemiology; Bacteriuria - microbiology; Bacteriuria - prevention & control; Biological and medical sciences; Cystitis - epidemiology; Cystitis - microbiology; Cystitis - prevention & control; Escherichia coli; Escherichia coli - classification; Escherichia coli - isolation & purification; Escherichia coli - pathogenicity; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Escherichia coli Infections - prevention & control; Female; Human bacterial diseases; Humans; Infectious Disease; Infectious diseases; Longitudinal Studies; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Prospective longitudinal study; Prospective Studies; Pyelonephritis - epidemiology; Pyelonephritis - microbiology; Pyelonephritis - prevention & control; Recurrence; Serogroups; Urinary system involvement in other diseases. Miscellaneous; Urinary tract infections; Urinary Tract Infections - microbiology; Urinary tract. Prostate gland; Urine - microbiology; Prospective longitudinal study; Urinary tract infections; Serogroups; Escherichia coli; Human; Relapse; Urinary tract infection; Urinary system disease; Bacteria; Female; Urinary tract disease; Behavior; Woman; Enterobacteriaceae
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2007.01.006

Summary Objective This study characterizes further the behavior of serologically classified isolates of Escherichia coli in women with recurrent urinary tract infections (UTIs). Methods A prospective, longitudinal study of 203 young to middle-aged women with UTIs was conducted. Seven hundred and sixty-one UTIs due to E. coli were identified in the 203 women during observation periods of 1.1–19.4 years. Isolates from urine were routinely serologically classified. Clusters of UTIs and rates per year of infections with the same serogroup were defined to quantify further UTIs. Results One hundred and forty-eight (73%) of the 203 women experienced 2–42 UTIs with E. coli . Fifteen percent of recurrences occurred within 1 month of the previous infection; 57%, 6 months; and 70%, 1 year. During the first four months, recurrences with the same serogroup accounted for 81–50% of recurrences; thereafter, recurrences with a different serogroup were more frequent. Clusters of UTIs occurred in 52% of the 148 women and ranged in size from 2–5 infections. Multiple recurrences with the same serogroup were more frequently caused by a few common serogroups. Conclusions Isolates of a few common serogroups of E. coli were associated with the great majority of both index and recurrent UTIs. Some isolates of both common and less common serogroups were associated with multiple recurrences with the same serogroup. The wide range in rates/year among recurrences with isolates of different serogroups in individual women were consistent with the hypothesis that these differences were more likely to be due to differences in virulence of the isolates than to host factors.