Johnson James R, Scheutz Flemming, Ulleryd Peter, Kuskowski Michael A, O'Bryan Timothy T, Sandberg Torsten
Mucosal and Vaccine Research Center, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN 55417, USA.
Clin Infect Dis. 2005 Mar 15;40(6):813-22. doi: 10.1086/428048. Epub 2005 Feb 16.
Host-pathogen relationships in men with febrile urinary tract infection (FUTI) are poorly understood.
Phylogenetic background, extended virulence genotypes, and serotypes were determined for 70 Escherichia coli isolates recovered from urine samples obtained from men with FUTI for comparison with available data for 70 E. coli rectal isolates recovered from uninfected men. Bacterial traits were assessed in relation to underlying host characteristics (age, compromise status, and history of urinary tract infection) and acute manifestations (bacteremia, flank pain, and serum prostate-specific antigen [PSA] level).
Compared with rectal isolates, FUTI isolates exhibited a significantly higher prevalence of virulence-associated phylogenetic groups, serotypes, and extraintestinal virulence genes. The latter included traditional prostatitis-associated traits (e.g., hemolysin and cytotoxic necrotizing factor), as well as unconventional traits, such as outer membrane protease T. These bacterial traits occurred largely independent of host age, urological compromise status, urinary tract infection history, and acute manifestations. However, certain traits were less prevalent in association with use of urinary tract instrumentation and significantly predicted elevated PSA levels.
Considerable virulence capability may be required for an E. coli strain to cause FUTI in men, regardless of whether most compromising conditions are present. Bacterial traits that promote prostatic invasion may be relevant for the pathogenesis of FUTI, even among men without classic manifestations of acute prostatitis.
发热性尿路感染（FUTI）男性患者的宿主-病原体关系尚不清楚。
对从FUTI男性患者尿液样本中分离出的70株大肠杆菌进行系统发育背景、扩展毒力基因型和血清型的测定，并与从未感染男性中分离出的70株大肠杆菌直肠分离株的现有数据进行比较。根据潜在宿主特征（年龄、健康状况受损情况和尿路感染史）和急性表现（菌血症、胁腹疼痛和血清前列腺特异性抗原[PSA]水平）评估细菌特征。
与直肠分离株相比，FUTI分离株在与毒力相关的系统发育组、血清型和肠外毒力基因方面的流行率显著更高。后者包括传统的前列腺炎相关特征（如溶血素和细胞毒性坏死因子），以及非传统特征，如外膜蛋白酶T。这些细菌特征在很大程度上与宿主年龄、泌尿系统受损状况、尿路感染史和急性表现无关。然而，某些特征在使用尿路器械的情况下不太常见，并且显著预测PSA水平升高。
大肠杆菌菌株可能需要相当强的毒力才能在男性中引起FUTI，无论是否存在大多数损害情况。促进前列腺侵袭的细菌特征可能与FUTI的发病机制相关，即使在没有急性前列腺炎典型表现的男性中也是如此。
