Acquisition of a pathogenicity island in an Escherichia coli clinical isolate causing febrile urinary tract infection

• Published in: European journal of clinical microbiology & infectious diseases Vol. 30; no. 12; pp. 1543 - 1550
• Main Authors: Soto, S. M., Zúñiga, S., Ulleryd, P., Vila, J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-12-2011; Springer; Springer Nature B.V
• Subjects: Bacteria; Bacterial diseases; Bacterial diseases of the urinary system; Biofilms; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Clinical isolates; Cluster Analysis; Defense mechanisms; Dehydrogenases; DNA, Bacterial - genetics; E coli; Electrophoresis, Gel, Pulsed-Field; Escherichia coli; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - microbiology; Evolution; Evolutionary genetics; Gene Transfer, Horizontal; Genes; Genomic Islands; Genotype; Horizontal transfer; Human bacterial diseases; Humans; Infectious diseases; Infectious Medicine; Infektionsmedicin; Internal Medicine; Kinases; Male; Medical Microbiology; Medical sciences; Molecular Typing; Nephrology. Urinary tract diseases; pathogenicity islands; Pathogens; Patients; Phylogenetics; Pulsed-field gel electrophoresis; Recurrence; Recurrent infection; Urinary system involvement in other diseases. Miscellaneous; Urinary tract; Urinary tract diseases; Urinary tract infections; Urinary Tract Infections - microbiology; Urinary tract. Prostate gland; Urogenital system; Virulence; virulence factors; Virulence Factors - genetics; Sweden; Prostatitis; Virulence Factor; Fumarate Hydratase; Febrile Urinary Tract Infection; Pathogenicity Island; Pathogenicity; Urinary tract infection; Urinary system disease; Microbiology; Escherichia coli; Bacteria; Urinary tract disease; Clinical isolate; Fever; Enterobacteriaceae
• ISSN: 0934-9723; 1435-4373; 1435-4373
• DOI: 10.1007/s10096-011-1258-2

Urinary tract infections (UTI) are less common in men than in women, and uropathogenic
Escherichia coli
(UPEC) is the most frequent etiological agent. Recurrent UTI in men have often been reported as a relapse with the same strain as the index infection. The persistence of the same
E. coli
strain within the urinary tract has often been explained by a prostatic focus. The aim of this study was to determine whether recurrence was associated with relapse or reinfection and the possible effect of treatment on the content of virulence factors of the isolates causing these infections. Thirty
E. coli
isolates were collected from 15 patients with a febrile UTI having a bacteriological recurrence during long-term follow-up. These isolates were analyzed by pulsed-field gel electrophoresis (PFGE) and virulence profiling in order to determine whether they constituted relapse or reinfection. Five recurrences were categorized as relapse and nine as reinfections. The results obtained showed that the horizontal transfer of virulence factors contained in a pathogenicity island had occurred in one isolate. This event is possible in vivo and allows bacteria to become more virulent and, perhaps, cause greater damage. The acquisition of virulence genes by horizontal gene transfer is an ongoing process of evolution that continuously leads to new bacterial pathotypes.