Roles of host and bacterial virulence factors in the development of upper urinary tract infection caused by Escherichia coli

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Chin-Chung TsengJeng-Jong Huang

Abstract

Aims of this study are to identify host and Escherichia coli virulence factors associated with upper urinary tract infection (UTI) by comparing them with those for lower UTI and determining the association between major predisposing host factors for upper UTI and urovirulence genes for E coli. Host factors and urovirulence genes of E coli associated with bacteremia in patients with upper UTI and their interactions also were studied. One hundred thirty-nine adult patients who fulfilled clinical diagnostic criteria for upper (n = 81) or lower UTI (n = 58) caused by E coli between January 1997 and December 1999 were retrospectively enrolled into this study. Old age (> or =60 years), male sex, diabetes with poor blood glucose control (ie, glycosylated hemoglobin A1C > or = 8.1%), immunosuppression, and urinary tract obstruction were more frequently associated host factors for patients with upper UTI than for those with lower UTI. Using polymerase chain reaction, the papG class II allele was detected more frequently for E coli strains isolated from patients with upper UTI than for those from patients with lower UTI (85% versus 52%; P < 0.0001). Multivariate analysis showed that diabetes with poor blood glucose control, immunosuppres...Continue Reading

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