Nascimento Júllia A S, Santos Fernanda F, Santos-Neto José F, Trovão Liana O, Valiatti Tiago B, Pinaffi Isabel C, Vieira Mônica A M, Silva Rosa M, Falsetti Ivan N, Santos Ana C M, Gomes Tânia A T
Laboratório Experimental de Patogenicidade de Enterobactérias (LEPE), Disciplina de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia (DMIP), Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-062, Brazil.
Laboratório Alerta, Disciplina de Infectologia, Departamento de Medicina, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo 04039-032, Brazil.
Microorganisms. 2022 Jan 27;10(2):302. doi: 10.3390/microorganisms10020302.
Urinary tract infections (UTI) affect community and healthcare patients worldwide and may have different clinical outcomes. We assessed the phylogenetic origin, the presence of 43 virulence factors (VFs) of diarrheagenic and extraintestinal pathogenic , and the occurrence of hybrid strains among isolates from 172 outpatients with different types of UTI. Isolates from phylogroup B2 (46%) prevailed, followed by phylogroups A (15.7%) and B1 (12.2%), with similar phylogenetic distribution in symptomatic and asymptomatic patients. The most frequent VFs according to their functional category were (94.8%), (83.1%), (63.3%), (57.6%), and (22%). Using published molecular criteria, 34.3% and 18.0% of the isolates showed intrinsic virulence and uropathogenic potential, respectively. Two strains carried the and genes and one the gene, which classified them as hybrid strains. These hybrid strains interacted with renal and bladder cells, reinforcing their uropathogenic potential. The frequency of UPEC strains bearing a more pathogenic potential in the outpatients studied was smaller than reported in other regions. Our data contribute to deepening current knowledge about the mechanisms involved in UTI pathogenesis, especially among hybrid UPEC strains, as these could colonize the host's intestine, leading to intestinal infections followed by UTI.
尿路感染（UTI）影响着全球社区和医疗机构中的患者，并且可能有不同的临床结果。我们评估了172例不同类型尿路感染门诊患者分离株的系统发育起源、43种致泻性和肠外致病性毒力因子（VF）的存在情况以及杂交菌株的发生情况。B2菌群的分离株占主导（46%），其次是A菌群（15.7%）和B1菌群（12.2%），有症状和无症状患者的系统发育分布相似。根据功能类别，最常见的VF依次为[具体因子1]（94.8%）、[具体因子2]（83.1%）、[具体因子3]（63.3%）、[具体因子4]（57.6%）和[具体因子5]（22%）。根据已发表的分子标准，分别有34.3%和18.0%的分离株显示出内在毒力和尿路致病潜力。两株携带[具体基因1]和[具体基因2]，一株携带[具体基因3]，这些菌株被归类为杂交菌株。这些杂交菌株与肾细胞和膀胱细胞相互作用，增强了它们的尿路致病潜力。在所研究的门诊患者中，具有更高致病潜力的尿路致病性大肠杆菌（UPEC）菌株的频率低于其他地区报道的频率。我们的数据有助于深化目前对UTI发病机制所涉及机制的认识，特别是在杂交UPEC菌株中，因为这些菌株可能定植于宿主肠道，导致肠道感染继而引发UTI。
