Rana Pranav S J B, Aljabban Jihad, Prarat Melanie, Pancholi Preeti, Balada-Llasat Joan Miquel, Stephens Julie, Webb Amy, Chen Liang, Brodsky Sergey V, Nadasdy Tibor, Zhang Yan, Parikh Samir V, Wozniak Daniel J, Wang Shu-Hua, Olson Michael, Satoskar Anjali A
Department of Microbiology, College of Arts and Sciences, The Ohio State University, Columbus, Ohio, USA.
Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Kidney Int Rep. 2022 Aug 5;7(10):2264-2278. doi: 10.1016/j.ekir.2022.07.010. eCollection 2022 Oct.
infection-associated glomerulonephritis (SAGN), is an autoimmune sequela of infection affecting a subset of infected patients without specific predictive factors, frequently presenting with acute nephritic syndrome and propensity for chronic kidney disease. We performed a comparative genotypic and phenotypic analysis of isolates from patients that did and those that did not develop SAGN.
We had 22 culture-proven cases of SAGN from Ohio State University Wexner Medical Center (OSUWMC) from 2004 to 2016, 9 of 22 being blood cultures, with archived isolates. These, along with blood culture isolates from 12 patients with no clinical evidence of SAGN (between ages 40 to 80 years) over the same period were used for genotyping. For host demographic comparison, we used all available SAGN cases ( = 85, including those with positive cultures other than blood; and patients with kidney biopsies received from referring hospitals) and all OSUWMC patients with positive cultures without glomerulonephritis (GN) ( = 23,496).
Multiple sequence types (STs) suggesting strain diversity was seen in the GN isolates with mainly clonal complexes (CC) 5 and 59. Mutations in the operon were identified in significantly higher number of the GN isolates (83%) than non-GN isolates (16%). Significant differences in β-hemolysis and biofilm formation was also observed between the groups.
The functionality of these mutants remains to be seen, but the presently known effects of reduced function, namely increased surface adhesins, biofilm formation, and persistent bacteremia could be important microbial factors predisposing to SAGN and testing for them early during infection could help to predict its development.
感染相关性肾小球肾炎（SAGN）是感染后的一种自身免疫后遗症，影响一部分没有特定预测因素的感染患者，常表现为急性肾炎综合征，并易于发展为慢性肾脏病。我们对发生和未发生SAGN的患者分离株进行了基因型和表型的比较分析。
我们有2004年至2016年来自俄亥俄州立大学韦克斯纳医学中心（OSUWMC）的22例经培养证实的SAGN病例，其中22例中有9例为血培养，有存档分离株。这些分离株与同期12例无SAGN临床证据（年龄在40至80岁之间）患者的血培养分离株一起用于基因分型。为了进行宿主人口统计学比较，我们使用了所有可用的SAGN病例（n = 85，包括血培养以外其他培养阳性的病例；以及从转诊医院接受肾活检的患者）和所有OSUWMC培养阳性但无肾小球肾炎（GN）的患者（n = 23,496）。
在GN分离株中观察到多种序列类型（STs），提示菌株多样性，主要克隆复合体（CC）为5和59。与非GN分离株（16%）相比，GN分离株中发现的操纵子突变数量显著更多（83%）。两组之间在β溶血和生物膜形成方面也观察到显著差异。
这些突变体的功能还有待观察，但目前已知的功能降低的影响，即表面黏附素增加、生物膜形成和持续性菌血症，可能是导致SAGN的重要微生物因素，在感染早期对其进行检测可能有助于预测SAGN的发生。
