Morales-Espinosa Rosario, Hernandez-Castro Rigoberto, Delgado Gabriela, Mendez Jose Luis, Navarro Armando, Manjarrez Angel, Cravioto Alejandro
Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
J Infect Dev Ctries. 2016 Apr 28;10(4):317-28. doi: 10.3855/jidc.6652.
Any microorganism is capable of causing urinary tract infections (UTI). However, Uropathogenic Escherichia coli (UPEC) is responsible for the majority of UTI. A variety of virulence genes have been identified in UPEC. Diverse epidemiological studies support that specific subsets of genes are characteristic of each E. coli uropathogenic subtype involved in the development of cystitis, pyelonephritis, and urosepsis.
Twenty-three E. coli strains isolated from women with cystitis, 25 from men with prostatitis were characterized according to serotype, virulence genes, PFGE profile and susceptibility antimicrobials.
E. coli O25:H4-ST131 was more frequently isolated from cystitis than prostatitis. The majority of cystitis strains presented almost all the virulence genes, contrary to 60% of prostatitis strains. The strains characterized by serology, PFGE and MLST and virulence profile showed that cystitis strains shared a lineage with their own genomic fingerprint, indicating that these strains derived from a common ancestor. The prostatitis strains showed serotypes diverse and much higher degree of genetic diversity, indicating that they are an unrelated group. More than 50% of isolates were resistant to at least 7 of the antimicrobials tested. Antibiotic-tolerant cells were observed, presenting with more frequency in response chloramphenicol, tetracycline, trimethoprim-sulfometoxazole and dicloxicillin.
Persister cells can be detected from the beginning of the infection. The importance of these persister cells that exhibit multidrug tolerance is that a single surviving bacterium can initiate again an infection making it clinical relevant in the chronic urinary tract infection.
任何微生物都有可能引发尿路感染(UTI)。然而,尿路致病性大肠杆菌(UPEC)是导致大多数尿路感染的原因。在尿路致病性大肠杆菌中已鉴定出多种毒力基因。各种流行病学研究表明,特定的基因子集是参与膀胱炎、肾盂肾炎和尿脓毒症发展的每种大肠杆菌尿路致病亚型的特征。
从膀胱炎女性患者中分离出23株大肠杆菌,从前列腺炎男性患者中分离出25株大肠杆菌,根据血清型、毒力基因、脉冲场凝胶电泳(PFGE)图谱和抗菌药物敏感性进行鉴定。
与前列腺炎相比,从膀胱炎患者中更频繁地分离出大肠杆菌O25:H4-ST131。大多数膀胱炎菌株几乎呈现所有毒力基因,而前列腺炎菌株只有60%呈现所有毒力基因。通过血清学、PFGE和多位点序列分型(MLST)以及毒力谱鉴定的菌株表明,膀胱炎菌株具有与其自身基因组指纹相同的谱系,这表明这些菌株源自共同祖先。前列腺炎菌株的血清型多样,遗传多样性程度更高,表明它们是一个不相关的群体。超过50%的分离株对至少7种测试抗菌药物耐药。观察到抗生素耐受细胞,对氯霉素、四环素、甲氧苄啶-磺胺甲恶唑和双氯西林有更高频率的反应。
在感染初期即可检测到持留菌。这些表现出多药耐受性的持留菌的重要性在于,单个存活细菌可再次引发感染,这使其在慢性尿路感染中具有临床相关性。