Connell H, de Man P, Jodal U, Lincoln K, Svanborg C
Department of Medical Microbiology, Lund University, Sweden.
Microb Pathog. 1993 Jun;14(6):463-72. doi: 10.1006/mpat.1993.1045.
Hemolysins are cytolytic proteins which have been extensively characterized at the molecular level, however, their in vivo functions remain unclear. This study analyzed the association of hemolysin production with the inflammatory response in patients with urinary tract infection (UTI). Infants and children with their first episode of UTI (n = 644) were followed prospectively. The body temperature, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), urinary leucocyte count and renal concentrating capacity were used as measures of the inflammatory response. The hemolytic genotype (hly) of the Escherichia coli strain from each UTI episode was defined by DNA-DNA hybridization, and the phenotype by hemolysis in blood agar. There was no significant increase in the level of fever, CRP, ESR, or decrease in renal concentrating capacity during UTI episodes caused by hly positive compared to hly negative E. coli. Multiple regression analysis did not demonstrate significant associations of hly with elevated fever, CRP, ESR or reduced renal concentrating capacity. In contrast, patients infected with P fimbriated E. coli strains had higher fever, CRP, ESR and lower renal concentrating capacity than those infected with other strains. This association was not influenced by the hly genotype of the P fimbriated strains. The frequency of hly+ strains was not significantly higher in the subset of patients assigned a diagnosis of acute pyelonephritis compared to asymptomatic bacteriuria. This was in contrast to P fimbriae, which were accumulated in acute pyelonephritis. The results suggested that the acute inflammatory response to E. coli UTI is independent of hemolysin production. The inflammatogenic potential of uropathogenic E. coli clones was better described by the presence or absence of P-fimbriae than by hemolysin.
溶血素是一类在分子水平上已得到广泛表征的细胞溶解蛋白，然而，它们在体内的功能仍不清楚。本研究分析了溶血素产生与尿路感染（UTI）患者炎症反应之间的关联。对首次发生UTI的婴幼儿（n = 644）进行了前瞻性随访。体温、C反应蛋白（CRP）、红细胞沉降率（ESR）、尿白细胞计数和肾脏浓缩能力被用作炎症反应的指标。通过DNA-DNA杂交确定每次UTI发作时大肠杆菌菌株的溶血基因型（hly），并通过血琼脂中的溶血情况确定表型。与hly阴性的大肠杆菌相比，由hly阳性的大肠杆菌引起的UTI发作期间，发热、CRP、ESR水平没有显著升高，肾脏浓缩能力也没有降低。多元回归分析未显示hly与发热升高、CRP、ESR或肾脏浓缩能力降低之间存在显著关联。相比之下，感染P菌毛大肠杆菌菌株的患者比感染其他菌株的患者发热更高、CRP和ESR更高，肾脏浓缩能力更低。这种关联不受P菌毛菌株hly基因型的影响。与无症状菌尿症患者相比，诊断为急性肾盂肾炎的患者亚组中hly+菌株的频率没有显著更高。这与P菌毛相反，P菌毛在急性肾盂肾炎中会聚集。结果表明，对大肠杆菌UTI的急性炎症反应与溶血素的产生无关。与溶血素相比，尿路致病性大肠杆菌克隆的致炎潜力通过P菌毛的有无能得到更好的描述。
