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Comparison of phylogroups and virulence genes of Escherichia coli obtained from healthy humans and patients with urinary tract infection in Denmark

Abstract number: P1625

Jakobsen L., Spangholm D.J., Skjøt-Rasmussen L., Porsbo L.J., Olsen K.E.P., Hammerum A.M., Frimodt-Møller N.

Objectives:Escherichia coli (Ec) causing urinary tract infections (UTI) in women is believed to stem from the patients own faecal flora. Ec causing UTI often belong to phylogroup B2, which is more virulent than the other common phylogroups. The objective was to investigate the phylogroup distribution and the presence of selected virulence genes (VGs) often detected in extra-intestinal pathogenic Ec of Ec isolates from healthy humans and patients with UTI in Denmark.

Methods: In 2004, 109 Ec faecal isolates were obtained from healthy humans as part of the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP). Furthermore, 131 Ec urine isolates were collected from Danish patients with UTI in 2005. All isolates were investigated by three multiplex PCR reactions for their phylogenetic background (A, B1, B2, D) and presence of eight VGs (kpsM II, iutA, papA, papC, hlyD, sfaS, focG, afa). Results were analysed using Chi-square, Fisher's exact and Mann-Whitney test.

Results: Healthy human isolates grouped into phylogroups A (24%), B1 (16%), B2 (36%) and D (25%) and patient isolates grouped into phylogroups A (22%), B1 (7%), B2 (47%) and D (24%). B1 isolates were more prevalent in healthy humans than patients (p = 0.0371). Similar prevalences of group A, B2 and D isolates from healthy humans and patients were observed.

The 109 healthy human and the 131 patient isolates had similar distributions of the VGs (Table 1).

B2 isolates from both groups carried from 0–6 VGs. The median no. of VGs carried by B2 isolates were highest in isolates from patients (3.56 VGs/isolate) compared to isolates from healthy humans (2.63 VGs/isolate) (p = 0.0014). B2 isolates with iutA, papA, papC and hlyD were significantly more prevalent among patient isolates (Table 1). B2 isolates from both healthy humans and patients carried significantly more VGs compared to phylogroups A, B1 and D.

Conclusions: Phylogroups A, B1, B2, D and VGs (kpsM II, iutA, papA, papC, hlyD, sfaS, focG, afa) were all detected among Ec isolates from healthy humans and patients.

The prevalence of phylogroup A, B2, D and VGs were similar between the healthy human and patient isolates.

Comparing B2 isolates only, iutA, papA, papC and hlyD were significantly more prevalent among patient isolates.

The median no. of VGs/isolate was highest in B2 isolates from patients compared to healthy human isolates.

B2 isolates had more VGs than phylogroup A, B1 and D in both healthy human and patient isolates.

Table 1. Distribution of virulence genes in Escherichia coli isolates from healthy humans and patientswith UTI

Session Details

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