Urinary Tract Infections in Renal Transplant Recipients: Virulence Traits of Uropathogenic Escherichia coli

• Published in: Transplantation proceedings 2010-03, Vol.42 (2), p.483-485
• Main Authors: Merçon, M, Regua-Mangia, A.H, Teixeira, L.M, Irino, K, Tuboi, S.H, Goncalves, R.T, Santoro-Lopes, G
• Format: Article
• Language: English
• Subjects: Animals; Bacterial diseases; Bacterial diseases of the urinary system; Biological and medical sciences; Escherichia coli Infections - epidemiology; Escherichia coli Infections - genetics; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Genotype; Goats; Guinea Pigs; Hemagglutination Inhibition Tests; Human bacterial diseases; Humans; Infectious diseases; Kidney Transplantation - adverse effects; Male; Medical History Taking; Medical sciences; Pancreatitis-Associated Proteins; Phenotype; Pyelonephritis - epidemiology; Pyelonephritis - microbiology; Rabbits; Retrospective Studies; Sheep; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Urinary Tract Infections - epidemiology; Urinary Tract Infections - genetics; Urinary Tract Infections - microbiology; Urine - microbiology; Uropathogenic Escherichia coli - isolation & purification; Uropathogenic Escherichia coli - pathogenicity
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.01.049

Abstract Background Urinary tract infection (UTI) is the most common infectious complication after renal transplantation. Most infections are caused by uropathogenic Escherichia coli (UPEC). There are limited data on the prevalence of virulence traits among UPEC isolated from renal transplant recipients. This study compared the phenotypic and genotypic profiles of UPEC strains isolated from recipients with those from control patients. Methods E coli isolates that caused UTI in recipients versus nonimmunosuppressed control patients were characterized according to phylogenetic group and the presence of urovirulence genes pap1/pap2; sfa1/sfa2; afa1/afa2; aer1/aer2; and cnf1/cnf2. Results Thirty-six UPEC isolates from recipients and another 27 from control individuals were included in the study. The proportion of episodes of pyelonephritis in recipients (50%) versus control subjects (41%) was similar ( P = .46). However, secondary bacteremia was observed only among recipients ( n = 8; P < .001). There was no significant difference in the distribution of phylogenetic groups or the prevalence of analyzed virulence traits between UPEC isolated from the 2 groups. Nevertheless, strains associated with secondary bacteremia in recipients showed a higher prevalence of mannose-resistant hemagglutination ( P = .013). Conclusion The phenotypic and genotypic characteristics of UPEC isolated from recipients were similar to those from control patients at a tertiary care center. Secondary bacteremia in recipients was associated with a higher prevalence of mannose-resistant hemagglutination.