Clonality and presence of fimbrial adhesin genes of Escherichia coli isolated in recurrent cystitis from a 48-year-old female

Abstract number: P1298

Rodrigues V., Simões S., Morgado M., Morgado D., Hanscheid T., Melo-Cristino J., Duarte A.

Objectives: Urinary tract infections (UTI) are a common healthcare problem. Recurrent UTI in healthy, nonpregnant women is defined as three or more episodes of UTI during a 12-month period. It affects an estimated 20% of women at some time during their lifetimes. The uropathogenic E. coli (UPEC) possess adherence factors called pili or fimbriae (type 1 and P), which allow them to successfully initiate UTI infections. This adhesins are involved in the colonisation of mucosal cells, proliferation and cell damage, thus increasing the time of survival in the host. The aim of this study was to determine the occurrence of virulence genes and verify the clonal relation of E. coli isolates from recurrent cystitis.

Methods: A total of five E. coli isolates were recovered from a 48 year old female with recurrent urinary tract infection. Three strains were isolated from urine during six months and two strains were isolated from perineum and rectal swabs, respectively. Identification and antimicrobial susceptibility testing was determinate by VITEK 2 system. The presence of fimbrial adhesins was performed by PCR, using two pairs of primers: PAP1/PAP2 and fimH_F/fimH_R that amplify type P and type 1 fimbrial adhesins, respectively. Clonal relationship was assessed by M13 fingerprinting.

Results: The strains showed the same resistance profile and were resistant to trimethoprim/sulfamethoxazole, ciprofloxacin, norfloxacin, and showed susceptibility to cephalosporins (2nd and 3th generation), nitrofurantoin and fosfomycin. All strains exhibited the type 1 fimbrial adhesin and the same M13 fingerprint profile, including the strains identified from perineum and rectal swab. These results suggest that recurrent infections are due to the patient's inability to eliminate the microorganism (relapse), and not by reinfection, since all strains isolated in the period of 6 months belong to the same clone.

Conclusions: One of the main factors for the occurrence of urinary tract infections is the presence of adhesins, allowing the adherence of bacteria to uroepithelium hindering its removal, even after therapy.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Location: Barcelona, Spain
Presentation type:
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