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Birgy A, Madhi F, Jung C, Levy C, Cointe A, Bidet P, Hobson CA, Bechet S, Sobral E, Vuthien H, Ferroni A, Aberrane S, Cuzon G, Beraud L, Gajdos V, Launay E, Pinquier D, Haas H, Desmarest M, Dommergues MA, Cohen R, Bonacorsi S. Diversity and trends in population structure of ESBL-producing Enterobacteriaceae in febrile urinary tract infections in children in France from 2014 to 2017. J Antimicrob Chemother 2021; 75:96-105. [PMID: 31617912 DOI: 10.1093/jac/dkz423] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/21/2019] [Accepted: 09/10/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The population structure of extraintestinal pathogenic Escherichia coli evolves over time, notably due to the emergence of antibiotic-resistant clones such as ESBL-producing Enterobacteriaceae (ESBL-E). OBJECTIVES To analyse by WGS the genetic diversity of a large number of ESBL-E isolated from urinary tract infections in children from paediatric centres across France between 2014 and 2017 and collected by the National Observatory of febrile urinary tract infection (FUTI) caused by ESBL-E. METHODS A total of 40 905 Enterobacteriaceae-positive urine cultures were identified. ESBL-E were found in 1983 samples (4.85%). WGS was performed on 251 ESBL-E causing FUTI. STs, core genome MLST (cgMLST), serotype, fimH allele, ESBL genes and presence of papGII key virulence factor were determined. RESULTS E. coli and Klebsiella pneumoniae were found in 86.9% (218/251) and 11.2% (28/251) of cases, respectively. Several STs predominate among E. coli such as ST131, ST38, ST69, ST73, ST95, ST405, ST12 and ST1193, while no ST emerged in K. pneumoniae. E. coli ST131, ST38 and ST1193 increased during the study period, with a heterogeneity in papGII prevalence (64.5%, 35% and 20% respectively). Most isolates harboured the CTX-M type (97%) with a predominance of blaCTX-M-15. blaCTX-M-27, an emerging variant in E. coli, is found in various STs. cgMLST enabled discrimination of clusters within the main STs. CONCLUSIONS The predominance of ST131, and the emergence of other STs such as ST38 and ST1193 combined with ESBL genes deserves close epidemiological surveillance considering their high threat in infectious disease. cgMLST could be a discriminant complementary tool for the analyses.
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Affiliation(s)
- André Birgy
- Université de Paris, IAME, INSERM, F-75018, Paris, France.,AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France
| | - Fouad Madhi
- Service de Pédiatrie Générale, Centre Hospitalier Intercommunal de Créteil, France.,Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France
| | - Camille Jung
- Service de Pédiatrie Générale, Centre Hospitalier Intercommunal de Créteil, France.,Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France
| | - Corinne Levy
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France.,Université Paris Est, IMRB-GRC GEMINI, ACTIV, 94000, Créteil, France
| | - Aurélie Cointe
- Université de Paris, IAME, INSERM, F-75018, Paris, France.,AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France
| | - Philippe Bidet
- Université de Paris, IAME, INSERM, F-75018, Paris, France.,AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France
| | | | - Stéphane Bechet
- Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France
| | - Elsa Sobral
- Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France
| | - Hoang Vuthien
- AP-HP, HU-Est Parisien site Trousseau, Service de Bactériologie, F-75012, Paris, France
| | - Agnès Ferroni
- AP-HP, Hopital Necker, Service de Microbiologie, University Paris Descartes, Paris, France
| | - Saïd Aberrane
- Microbiology Laboratory, Créteil Hospital, Créteil, France
| | - Gaëlle Cuzon
- Bacteriology-Hygiene Unit, Assistance Publique/Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France.,Université Paris Sud, LabEx LERMIT, Faculty of Medicine, Le Kremlin-Bicêtre, France.,Associated French National Reference Center for Antibiotic Resistance: Carbapenemase-producing Enterobacteriaceae, Le Kremlin-Bicêtre, France.,Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur, APHP-Université Paris Sud, Paris, France
| | - Laetitia Beraud
- Centre National de Référence des Légionelles, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Vincent Gajdos
- Service de Pédiatrie, Antoine Béclère University Hospital, Assistance Publique-Hôpitaux de Paris, Clamart, France.,Centre for Research in Epidemiology and Population Health, Villejuif, France
| | - Elise Launay
- Service de Pédiatrie Générale et Infectiologie Pédiatrique, Hôpital Femme-Enfant-Adolescent, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Didier Pinquier
- Unité de Pneumologie et Allergologie pédiatriques & CRCM mixte, Pédiatrie Médicale, CHU Charles Nicolle, Rouen, France
| | - Hervé Haas
- Hôpitaux pédiatriques CHU Lenval, Nice, France
| | - Marie Desmarest
- Service d'Accueil des Urgences Pédiatriques, AP-HP, Hôpital Robert Debré, Paris, France
| | - Marie-Aliette Dommergues
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Service de pédiatrie, centre hospitalier de Versailles, Le Chesnay, France
| | - Robert Cohen
- Groupe de Pathologie Infectieuse Pédiatrique (GPIP), Paris, France.,Centre de Recherche Clinique, Centre Hospitalier Intercommunal de Créteil, France.,Association Clinique Thérapeutique Infantile du Val de Marne (ACTIV), Saint Maur des Fossés, France.,Université Paris Est, IMRB-GRC GEMINI, ACTIV, 94000, Créteil, France.,Unité Court Séjour, Petits Nourrisson, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France
| | - Stéphane Bonacorsi
- Université de Paris, IAME, INSERM, F-75018, Paris, France.,AP-HP, Hôpital Robert Debré, Service de Microbiologie, F-75019, Paris, France
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2
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Amarsy R, Guéret D, Benmansour H, Flicoteaux R, Berçot B, Meunier F, Mougari F, Jacquier H, Pean de Ponfilly G, Clermont O, Denamur E, Teixeira A, Cambau E. Determination of Escherichia coli phylogroups in elderly patients with urinary tract infection or asymptomatic bacteriuria. Clin Microbiol Infect 2019; 25:839-844. [PMID: 30648603 DOI: 10.1016/j.cmi.2018.12.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/16/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Distinguishing between urinary tract infection (UTI) and asymptomatic bacteriuria (ABU) is difficult in the geriatric population since specific symptoms are often lacking. Escherichia coli is the most frequent UTI pathogen in this population but also a common urine colonizer. We hypothesized that detecting E. coli phylogroups B2 or D, which were previously associated with virulent strains responsible for extra-intestinal infections outside elderly patients, could help in distinguishing UTI from ABU. METHODS Consecutive cases of E. coli bacteriuria diagnosed in hospitalized patients >75 years old during 3 months were investigated for E. coli phylogroups. Multiplex PCR was used to search for several virulence genes as previously described. Characteristics of UTI and ABU cases, assessed retrospectively according to definitions and geriatric expertise, were compared. RESULTS Out of 233 bacteriuria cases, 60 were assessed to be UTI and 163 to be ABU, with 10 cases unclassified. E. coli strains belonging to the phylogroups B2 and D were significantly more frequent in UTI (48/60, 80%) than in ABU (101/163, 62%) by univariate and multivariate analyses (OR 3.05, 1.44-6.86, p 0.005). Out of all the host and bacterial characteristics studied, falls (p 0.032), comorbidities (p 0.041), and altered autonomy evaluated by a low activity of daily living score (p 0.027) were also associated with UTI using univariate and multivariate analysis. CONCLUSIONS Determination of the E. coli phylogroup, in addition to some host characteristics, can help to distinguish UTI from ABU in elderly patients with bacteriuria. If this hypothesis is confirmed by prospective studies, then inappropriate use of antibiotics may be reduced in ABU cases.
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Affiliation(s)
- R Amarsy
- APHP, Groupe Hospitalier Lariboisière-Fernand Widal, Equipe Opérationnelle d'Hygiène, Paris, France; Université Paris Diderot, INSERM, Sorbonne Paris Cité, IAME UMR 1137, Paris, France
| | - D Guéret
- Service de SSR Gériatrique, Centre Hospitalier de la Côte Fleurie, Equemauville, France
| | - H Benmansour
- AP-HP, Groupe Hospitalier Lariboisière-Fernand Widal, Service de Bactériologie-Virologie, Paris, France
| | - R Flicoteaux
- Biostatistics and Medical Information Team, Saint-Louis Hospital, Assistance Publique Hôpitaux de Paris, France; ECSTRA Team, Paris Diderot University, Sorbonne Paris Cité, Inserm UMR-1153, Epidemiology and Biostatistics Sorbonne Paris Cite Research Centre (CRESS), Paris, France
| | - B Berçot
- Université Paris Diderot, INSERM, Sorbonne Paris Cité, IAME UMR 1137, Paris, France; AP-HP, Groupe Hospitalier Lariboisière-Fernand Widal, Service de Bactériologie-Virologie, Paris, France
| | - F Meunier
- AP-HP, Groupe Hospitalier Lariboisière-Fernand Widal, Service de Bactériologie-Virologie, Paris, France
| | - F Mougari
- Université Paris Diderot, INSERM, Sorbonne Paris Cité, IAME UMR 1137, Paris, France; AP-HP, Groupe Hospitalier Lariboisière-Fernand Widal, Service de Bactériologie-Virologie, Paris, France
| | - H Jacquier
- Université Paris Diderot, INSERM, Sorbonne Paris Cité, IAME UMR 1137, Paris, France; AP-HP, Groupe Hospitalier Lariboisière-Fernand Widal, Service de Bactériologie-Virologie, Paris, France
| | - G Pean de Ponfilly
- AP-HP, Groupe Hospitalier Lariboisière-Fernand Widal, Service de Bactériologie-Virologie, Paris, France
| | - O Clermont
- Université Paris Diderot, INSERM, Sorbonne Paris Cité, IAME UMR 1137, Paris, France
| | - E Denamur
- Université Paris Diderot, INSERM, Sorbonne Paris Cité, IAME UMR 1137, Paris, France
| | - A Teixeira
- Service de Gériatrie, Hôpitaux Universitaires Saint Louis Lariboisière Fernand, Paris, France
| | - E Cambau
- Université Paris Diderot, INSERM, Sorbonne Paris Cité, IAME UMR 1137, Paris, France; AP-HP, Groupe Hospitalier Lariboisière-Fernand Widal, Service de Bactériologie-Virologie, Paris, France.
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3
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Díaz Álvarez M, Acosta Batista B, Pérez Córdova R, Hernández Robledo E. [Urinary tract infection caused by Enterobacteriaceae and its relationship with vesicoureteral reflux]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2017; 74:34-40. [PMID: 29364812 DOI: 10.1016/j.bmhimx.2016.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/23/2016] [Accepted: 10/19/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The first urinary tract infection can be a marker of a urinary tract anomaly, mainly vesicoureteral reflux. The aim of this work was to determine the association between isolated enterobacteria with the presence and grade of vesicoureteral reflux in neonatal patients with their first urinary tract infection. METHODS A retrospective, observational and analytic study of newborns, who were admitted to the Neonatal Department, University Pediatric Hospital "Juan Manuel Márquez," in Havana, Cuba, from 1992 to 2013 was conducted. The causal microorganism of urinary tract infection was from the Enterobacteriaceae family. They were evaluated by radio imaging. The association between the presence and grade of vesicoureteral reflux with the causal microorganism of the urinary tract infection was analyzed. RESULTS Newborn infants with urinary tract infection (450) were studied. Bacterial isolations in the urine cultures corresponded to E. coli in 316 cases (70.2%). The prevalence of vesicoureteral reflux was 18.2%. The presence of bacteria corresponding to the Enterobacteriaceae family (other than E. coli) had significant risk association with vesicoureteral reflux (OR: 2.02; p < 0.01) and vesicoureteral reflux classification (for higher grades, p < 0.01). CONCLUSIONS E. coli is the most frequent causal microorganism in neonatal urinary tract infection. However, an association between the isolation of a microorganism of the Enterobacteriaceae family different to E. coli with the presence of vesicoureteral reflux and mainly with higher grades of vesicoureteral reflux exists.
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Affiliation(s)
- Manuel Díaz Álvarez
- Servicio de Neonatología, Hospital Pediátrico Universitario "Juan M. Márquez", La Habana, Cuba.
| | - Bárbara Acosta Batista
- Servicio de Neonatología, Hospital Pediátrico Universitario "Juan M. Márquez", La Habana, Cuba
| | - Rodolfo Pérez Córdova
- Servicio de Neonatología, Hospital Pediátrico Universitario "Juan M. Márquez", La Habana, Cuba
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4
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Hogan J, Mahjoub F, Larakeb AS, Vu Thien H, Hosany A, Bensman A, Grimprel E, Bingen E, Bonacorsi S, Ulinski T. Escherichia coli virulence patterns may help to predict vesicoureteral reflux in paediatric urinary tract infections. Acta Paediatr 2015; 104:e460-5. [PMID: 26099938 DOI: 10.1111/apa.13092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 06/16/2015] [Indexed: 11/29/2022]
Abstract
AIM Ultrasound and biological tools are used to predict high-grade vesicoureteral reflux, but other markers are needed to better select patients who need voiding cystography. Our aim was to determine whether studying Escherichia coli virulence factors would help to predict vesicoureteral reflux in patients with their first acute pyelonephritis. METHODS We included children presenting with E. coli-related acute pyelonephritis or cystitis. Vesicoureteral reflux was assessed by voiding cystography. Virulence factors were identified by multiplex polymerase chain reaction. Statistical analysis was performed using logistic regression and the mean c-statistic test. RESULTS We included 198 patients: 30 with cystitis and 168 with acute pyelonephritis, including 46 with vesicoureteral reflux. High-grade reflux was associated with acute pyelonephritis caused by the E. coli lacking virulence factors papGII (82% versus 47%, p < 0.001) or papC (85% versus 53%, p < 0.001) or belonging to phylogenetic group A or B1. When we added genetic data (lack of papGII, fyuA and phylogenetic groups) to classical predictors of vesicoureteral reflux (ultrasound examination, gender, age), the ability to predict high-grade reflux increased, with the c-statistic rising from 0.88 to 0.93. CONCLUSION Bacterial virulence factors and clinical factors helped to predict high-grade reflux and may help to avoid unnecessary voiding cystographies.
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Affiliation(s)
- Julien Hogan
- Service de Néphrologie et Dialyse Pédiatrique; Assistance Publique-Hôpitaux de Paris and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Armand Trousseau; Paris France
| | - Farah Mahjoub
- Service de Microbiologie; Hôpital Robert Debré; AP-HP; Paris France
| | - Anis Skander Larakeb
- Service de Néphrologie et Dialyse Pédiatrique; Assistance Publique-Hôpitaux de Paris and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Armand Trousseau; Paris France
| | - Hoang Vu Thien
- Service de Microbiologie; Hôpital Armand Trousseau; AP-HP; Paris France
| | - Ahmad Hosany
- Service de Pédiatrie Générale; Hôpital Armand Trousseau; AP-HP; Paris France
| | - Albert Bensman
- Service de Néphrologie et Dialyse Pédiatrique; Assistance Publique-Hôpitaux de Paris and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Armand Trousseau; Paris France
- Université Pierre et Marie Curie (UMPC); Paris France
| | - Emmanuel Grimprel
- Service de Pédiatrie Générale; Hôpital Armand Trousseau; AP-HP; Paris France
- Université Pierre et Marie Curie (UMPC); Paris France
| | - Edouard Bingen
- Service de Microbiologie; Hôpital Robert Debré; AP-HP; Paris France
- Université Paris Diderot; Paris France
| | - Stéphane Bonacorsi
- Service de Microbiologie; Hôpital Robert Debré; AP-HP; Paris France
- Université Paris Diderot; Paris France
| | - Tim Ulinski
- Service de Néphrologie et Dialyse Pédiatrique; Assistance Publique-Hôpitaux de Paris and Inflammation-Immunopathology-Biotherapy Department (DHU i2B); Hôpital Armand Trousseau; Paris France
- Université Pierre et Marie Curie (UMPC); Paris France
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5
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Kõljalg S, Truusalu K, Stsepetova J, Pai K, Vainumäe I, Sepp E, Mikelsaar M. TheEscherichia coliphylogenetic group B2 with integrons prevails in childhood recurrent urinary tract infections. APMIS 2013; 122:452-8. [DOI: 10.1111/apm.12167] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 07/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Siiri Kõljalg
- Department of Microbiology; University of Tartu; Tartu
| | - Kai Truusalu
- Department of Microbiology; University of Tartu; Tartu
| | | | - Kristiine Pai
- Department of Microbiology; University of Tartu; Tartu
| | - Inga Vainumäe
- Department ofPediatrics; University of Tartu; Tartu Estonia
| | - Epp Sepp
- Department of Microbiology; University of Tartu; Tartu
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6
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Márquez-López A, Ruiz Del Castillo B, Cano ME, Rodríguez-Mirones C, Oteo J, Sáez D, Martínez-Martínez L. Production of HlyA and ClyA haemolysins among quinolone-resistant Escherichia coli isolated from clinical samples. SPRINGERPLUS 2013; 2:71. [PMID: 23543875 PMCID: PMC3607716 DOI: 10.1186/2193-1801-2-71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 02/15/2013] [Indexed: 11/10/2022]
Abstract
Most Escherichia coli resistant to quinolones are not haemolytic. The objective of this study was to determine the phylogroup, clonal relationship, mechanism of quinolone resistance and virulence factors in 70 haemolytic E. coli resistant to nalidixic acid. Sixty-six isolates contained the hlyA gene, belonged to phylogroup B2, and 61 of them presented low-level resistance to fluoroquinolones. Four isolates presented high-level resistance to fluoroquinolones, contained the clyA gene and were included in phylogroup D. One single isolate (phylogroup D, with low level resistance to fluoroquinolones) contained both cytotoxins.
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Affiliation(s)
- Alicia Márquez-López
- Service of Microbiology, University Hospital Marqués de Valdecilla-IFIMAV, Santander, Spain
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7
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Choi UY, Han SB, Lee SY, Kang JH, Kim SM, Ma SH. Regional differences in phylogenetic group of Escherichia coli strains isolated from children with urinary tract infection in Korea. KOREAN JOURNAL OF PEDIATRICS 2012; 55:420-3. [PMID: 23227061 PMCID: PMC3510271 DOI: 10.3345/kjp.2012.55.11.420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 06/12/2012] [Accepted: 07/01/2012] [Indexed: 01/08/2023]
Abstract
Purpose We phylogenetically analyzed the Escherichia coli strains isolated from children with urinary tract infection (UTI) in 2 regions of Korea. Virulence factors (VFs) and antibiotic resistance of the strains were also determined to compare the possible differences. Methods A total of 138 E. coli strains were collected from the 2 regions; Gyeongin (78 strains) and Gyeongnam (60 strains). The phylogenetic groups were determined using the triplex polymerase chain reaction (PCR) method and multiplex PCRs were used to detect 7 VFs genes (fimH, papC, iutA, hlyA, sfa/focDE, afa/draBC, and kpsMT II). We also tested for antibiotic resistance. Results Phylogenetic groups, B2 (61.6%) and D (26.8%), comprised the majority of all isolated strains. Regional comparisons revealed that more B2 strains and fewer non-B2 (A+B1+D) strains were found in Gyeongnam, than in the Gyeongin region (P=0.033), and certain VFs were predominantly detected in Gyeongnam (P<0.05). Neither regional nor phylogenetic differences, in antibiotic resistance of the strains, were significant. Conclusion We were able to confirm that the geographic location is an important determinant of the distribution of the phylogenetic groups and VFs among the E. coli strains that cause UTI in children.
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Affiliation(s)
- Ui-Yoon Choi
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
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8
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Lukacik P, Barnard TJ, Keller PW, Chaturvedi KS, Seddiki N, Fairman JW, Noinaj N, Kirby TL, Henderson JP, Steven AC, Hinnebusch BJ, Buchanan SK. Structural engineering of a phage lysin that targets gram-negative pathogens. Proc Natl Acad Sci U S A 2012; 109:9857-62. [PMID: 22679291 PMCID: PMC3382549 DOI: 10.1073/pnas.1203472109] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Bacterial pathogens are becoming increasingly resistant to antibiotics. As an alternative therapeutic strategy, phage therapy reagents containing purified viral lysins have been developed against gram-positive organisms but not against gram-negative organisms due to the inability of these types of drugs to cross the bacterial outer membrane. We solved the crystal structures of a Yersinia pestis outer membrane transporter called FyuA and a bacterial toxin called pesticin that targets this transporter. FyuA is a β-barrel membrane protein belonging to the family of TonB dependent transporters, whereas pesticin is a soluble protein with two domains, one that binds to FyuA and another that is structurally similar to phage T4 lysozyme. The structure of pesticin allowed us to design a phage therapy reagent comprised of the FyuA binding domain of pesticin fused to the N-terminus of T4 lysozyme. This hybrid toxin kills specific Yersinia and pathogenic E. coli strains and, importantly, can evade the pesticin immunity protein (Pim) giving it a distinct advantage over pesticin. Furthermore, because FyuA is required for virulence and is more common in pathogenic bacteria, the hybrid toxin also has the advantage of targeting primarily disease-causing bacteria rather than indiscriminately eliminating natural gut flora.
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Affiliation(s)
- Petra Lukacik
- Laboratory of Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Travis J. Barnard
- Laboratory of Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Paul W. Keller
- Laboratory of Structural Biology, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Kaveri S. Chaturvedi
- Center for Women’s Infectious Diseases Research, Washington University School of Medicine, St. Louis, MO 63110; and
| | - Nadir Seddiki
- Laboratory of Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - James W. Fairman
- Laboratory of Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Nicholas Noinaj
- Laboratory of Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Tara L. Kirby
- Laboratory of Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Jeffrey P. Henderson
- Center for Women’s Infectious Diseases Research, Washington University School of Medicine, St. Louis, MO 63110; and
| | - Alasdair C. Steven
- Laboratory of Structural Biology, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892
| | - B. Joseph Hinnebusch
- Laboratory of Zoonotic Pathogens, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT 59840
| | - Susan K. Buchanan
- Laboratory of Molecular Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
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9
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Zeidan S, El Ghoneimi A, Peuchmaur M, Bingen E, Bonacorsi S. Effect of partial ureteral obstruction and bacterial virulence on the occurrence of renal scarring in a mouse model. Urology 2012; 80:486.e1-7. [PMID: 22516355 DOI: 10.1016/j.urology.2012.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 01/13/2012] [Accepted: 02/13/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the effect of the infection and the obstruction of urinary tract on renal parenchyma, we developed a model of ascending urinary infection in mice with partial unilateral obstructive uropathy. METHODS Six week-old CBA/J mice were operated on to perform a right partial ureteral obstruction and challenged transurethrally with Escherichia coli CFT073 (high virulent strain) or E. coli Mez (low virulent strain). Level of infection of urine and kidneys, score of inflammation and fibrosis of kidneys, and kidney weight ratio (KWR) in the short and long term were studied. RESULTS At short-term (72 hours) experimentation, partial ureteral obstruction does not influence the level of kidney infection in terms of bacterial count, and the score of inflammation regardless of whether a virulent or low virulent strain was used. At long-term (42 days) experimentation, E. coli Mez was eliminated from all mice kidneys, but CFT073 persisted in almost all; obstruction did not influence the level of kidney infection with CFT073 but a significant difference of KWR and the inflammation and fibrosis score between obstructed and unobstructed kidneys was found (P = .0078; P = .036, respectively). Although the E. coli Mez strain did not persist in renal parenchyma, severe damage of the renal parenchyma was observed. CONCLUSION The proposed model is similar to the obstructive uropathy in children in which ureteral obstruction is present before the onset of infection. The association of obstruction and urinary infection impairs kidney growth and favors the occurrence of renal damage.
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Affiliation(s)
- Smart Zeidan
- Department of Pediatric Surgery and Urology, AP-HP, Robert Debré University Hospital, University of Paris Diderot, Paris, France.
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Piatti G. Pathogenic potential of Escherichia coli from polymicrobial urinary tract infections. J Med Microbiol 2011; 60:1553-1554. [DOI: 10.1099/jmm.0.031138-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Gabriella Piatti
- Section of Microbiology, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
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Saverino D, Schito AM, Mannini A, Penco S, Bassi AM, Piatti G. Quinolone/fluoroquinolone susceptibility in Escherichia coli correlates with human polymicrobial bacteriuria and with in vitro interleukine-8 suppression. ACTA ACUST UNITED AC 2010; 61:84-93. [PMID: 21070386 DOI: 10.1111/j.1574-695x.2010.00751.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Urinary tract infections (UTIs) are frequently polymicrobial diseases mainly sustained by Escherichia coli in association with other opportunistic pathogens. Cystitis and pyelonephritis are usually accompanied by an inflammatory response, which includes neutrophil recruitment. Uropathogenic E. coli possess the ability to evade host defenses, modulating the innate immune response. The aim of this study was to determine whether particular E. coli strains correlate with polymicrobial bacteriuria and whether escape from the early host defenses and microbial synergy could lead to mixed UTIs. We evaluated 188 E. coli-positive urine samples and assessed the relationships among polymicrobism, neutrophil presence and several traits of E. coli isolates (virulence factors such as hlyA, fimA, papC and their relative products, i.e. hemolysin, type 1 and P fimbriae, and cnf1, their phylogenetic group) and their ability to suppress cytokine response in 5637 bladder epithelial cells. Escherichia coli susceptibility toward quinolones and fluoroquinolones, known to be linked to the pathogenicity of this species, was also considered. We found significant correlations among polymicrobial bacteriuria, absence of pyuria and quinolone/fluoroquinolone susceptibility of E. coli isolates and their enhanced capability to suppress interleukin-8 urothelial production when compared with the patterns induced by the resistant strains.
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Affiliation(s)
- Daniele Saverino
- Department of Experimental Medicine, Section of Human Anatomy, University of Genova, Genova, Italy
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Chiou YY, Chen MJ, Chiu NT, Lin CY, Tseng CC. Bacterial Virulence Factors are Associated With Occurrence of Acute Pyelonephritis but Not Renal Scarring. J Urol 2010; 184:2098-102. [DOI: 10.1016/j.juro.2010.06.135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Indexed: 10/19/2022]
Affiliation(s)
- Yuan-Yow Chiou
- Department of Pediatrics and Institute of Clinical Medicine, National Cheng Kung University Medical College and Hospital, Rende Shiang, Tainan, Taiwan
| | - Mei-Ju Chen
- Department of Long-Term Care, Chung Hwa University of Medical Technology, Rende Shiang, Tainan, Taiwan
| | - Nan-Tsing Chiu
- Department of Nuclear Medicine, National Cheng Kung University Medical College and Hospital, Rende Shiang, Tainan, Taiwan
| | - Ching-Yuang Lin
- Clinical Immunological Center, China Medical University Medical College and Hospital, Taichung, Taiwan
| | - Chin-Chung Tseng
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Rende Shiang, Tainan, Taiwan
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Doit C, Mariani-Kurkdjian P, Mahjoub-Messai F, Bidet P, Bonacorsi S, Carol A, Varon E, Bingen E. Epidemiology of pediatric community-acquired bloodstream infections in a children hospital in Paris, France, 2001 to 2008. Diagn Microbiol Infect Dis 2010; 66:332-5. [PMID: 20159378 DOI: 10.1016/j.diagmicrobio.2009.10.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Revised: 10/15/2009] [Accepted: 10/17/2009] [Indexed: 11/30/2022]
Abstract
In 2001 to 2008, we documented 483 cases of pediatric community-acquired bacteremia mostly because of Streptococcus agalactiae (< 4 days), Escherichia coli (4 days to 3 months), pneumococci (3 months to 5 years), and Staphylococcus aureus (> 5 years). Pneumococcal conjugate vaccination affected the serotype distribution of pneumococcal bacteremia but not its frequency. Serotype 19A represented 12% and 22% of pneumococci in the prevaccine and vaccine periods, respectively.
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Affiliation(s)
- Catherine Doit
- Service de Microbiologie, Hôpital Robert-Debré (AP-HP), Université Denis-Diderot-Paris 7, 75019 Paris, France
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Siliano PR, Rocha LA, Medina-Pestana JO, Heilberg IP. The role of host factors and bacterial virulence genes in the development of pyelonephritis caused by Escherichia coli in renal transplant recipients. Clin J Am Soc Nephrol 2010; 5:1290-7. [PMID: 20448070 DOI: 10.2215/cjn.06740909] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to determine the role of host factors and bacterial virulence genes in the development of pyelonephritis caused by Escherichia coli in renal transplant (Tx) recipients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A total of 328 E. coli isolates from cases of cystitis (Cys; n=239) or pyelonephritis (PN; n=89), with 169 from renal Tx recipients, were subjected to molecular analyses to identify P-fimbria subunits (PapC, PapG II, and PapGIII), G- and M-fimbriae, and aerobactin. The presence of antibiotic resistance was also determined. Parameters such as gender, age, immunosuppression regimens, causes of ESRD, kidney donor, intraoperative anastomosis, use of double J stent, trimethoprim/sulfamethoxazole (TMP/SMZ) prophylaxis, and time after Tx were evaluated. RESULTS A multivariate analysis showed a significant association between PN and renal Tx. In renal Tx recipients, the risk of occurrence of PN was significantly higher among males and for those no longer receiving TMP/SMZ prophylaxis. E. coli strains isolated from PN presented a lower prevalence of papGIII and lower rates of resistance to pipemidic acid. Although papGII was more prevalent in PN than in Cys, it was not independently associated with PN. CONCLUSIONS These findings suggested that renal Tx increases the risk for PN, and the male sex represented a host factor independently associated with risk, whereas the prophylaxis with TMP/SMZ was protective. The lack of papGIII and low resistance to first-generation quinolones were bacterial-independent risk factors for PN in Tx.
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