Abstract
Background Escherichia coli is among the most common uropathogens. Increased antibiotic resistance in Gram negative bacilli is global concern. Alternative therapeutic options including vaccines against uropathogenic E. coli (UPEC) have been developed. In this study, we compared the genotypic characteristics and antimicrobial susceptibility of UPEC according to phylogenetic groups. Methods We retrospectively reviewed the medical records of pyelonephritis patients with UPEC between February 2015 and June 2018. The study was conducted at a medical center in Korea. We compared the clinical and genotypic characteristics of UPEC according to phylogenetic groups. The phylogenetic groups and 29 virulence factors were identified using multiplex polymerase chain reaction. Results Phylogenetic group analysis revealed that most uropathogenic E. coli belonged to groups B2 and D: B2 (276, 77.7%), D (62, 17.5%), B1 (12, 3.4%), and A (5, 1.4%). Among the virulence factors, fyuA, fimH, traT, iutA, papG allele II, and papC were the most frequently observed. Phylogenetic group B2 was more closely related to virulence factors, including fimH, sfa/focED, focG, hlyA, cnf1, fyuA, and PAI, than group D. Groups B2 and D showed similar clinical presentations and complications. Group B2 had mostly healthcare-associated infections and antimicrobial resistance. Group D mostly had community-acquired infections. The K1 serotype was prevalent in group B2, and K5 was the most prevalent in group D. Conclusions Phylogenetic group B2 had more proportions and types of virulence factors than group D. Group B2 showed a high presentation of virulence factors related to adhesions and toxins. An increased presentation of antimicrobial resistance and healthcare-associated infections was also noted. Considering the genetic characteristics of UPEC, alternative therapeutic options targeting frequent virulence factors might be considered in addition to antibiotics.
Highlights
Escherichia coli is among the most common uropathogens
Considering the genetic characteristics of uropathogenic E. coli (UPEC), alternative therapeutic options targeting frequent virulence factors might be considered in addition to antibiotics
In this study, we compared the virulence factors and antimicrobial susceptibility according to the phylogenetic groups B2 and D, which accounted for the majority of uropathogeni E. coli, and determined whether differences exist in clinical manifestations between the two groups
Summary
Escherichia coli is among the most common uropathogens. Increased antibiotic resistance to gram negative bacilli is global concern. We compared the genotypic characteristics and antimicrobial susceptibility of UPEC according to phylogenetic groups. Clinical manifestations of UTI may differ depending on the underlying disease, preceding factors, and infecting bacteria [6,7]. These manifestations can be influenced by bacterial pathogenicity [8]. Studies on the differences in virulence factors and clinical characteristics of E. coli according to the phylogenetic group remain limited. In this study, we compared the virulence factors and antimicrobial susceptibility according to the phylogenetic groups B2 and D, which accounted for the majority of uropathogeni E. coli, and determined whether differences exist in clinical manifestations between the two groups. The clinical characteristics and predisposing factors between the two groups were examined
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
