Phylogenetic Groups and Virulence Factors of Escherichia coli Causing Urinary Tract Infection in Children

Ji Mok Kim; Eun Young Cho; Jae Ho Lee

doi:10.14776/piv.2015.22.3.194

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Kim, Cho, and Lee: Phylogenetic Groups and Virulence Factors of Escherichia coli Causing Urinary Tract Infection in Children

Original Article

Pediatr Infect Vaccine 2015;22(3):194-200.

Published online: 21 January 2015

DOI: https://doi.org/10.14776/piv.2015.22.3.194

Phylogenetic Groups and Virulence Factors of Escherichia coli Causing Urinary Tract Infection in Children

Ji Mok Kim, Eun Young Cho, Jae Ho Lee

Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea

Received 1 September 201528 October 2015 Accepted 6 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Urinary tract infection (UTI) is a common bacterial infection in children and Escherichia coli is a predominant pathogen. The purpose of this study is to evaluate phylogenetic groups and virulence factors off. COli causing UTI in children in Korea.

Methods

From October 2010 to April 2013, urinary E. Coli strains were isolated from the 33 pediatric patients of UTI. Multiplex polymerase chain reactions were performed to evaluate the phylogenetic groups and 5 virulence factor genes (fimH, sfa, papA, hy/A, and cnf1) of E. co/I'. Distribution of molecular characteristics off. CO// was analyzed by clinical diagnosis and accompanying vesicoureteral reflux (VUR).

Results

Most (84.8%) uropathogenic E. coli were belonged to phylogenetics group 82 and the others (15.2%) were belonged to group D. The virulence factors were distributed as: fimH (100%), sfa (100%), hy/A (63.6%), cnf/ (63.6%), and papA (36.4%). According to clinical diagnosis, phylogenetic distribution of E. coli' strain was 92.3% 0f 82 and 7.7% of D in acute pyelonephritis and 57.1% 0f 82 and 42.9% of D in cystitis. Distribution of virulence factors was similar in both groups. In patients with acute pyelonephritis, phylogenetic distribution was similar in VUR and non—VUR group, but proportion of papA genes were lower in VUR group than that of non-VUR group (43.8% vs. 20.0%, P=0.399).

Conclusions

This study provides current epidemiologic molecular data of E. coli causing pediatric UTI in Korea and will be a fundamental for understanding the pathogenesis of pediatric UTI.

Keywords: Escherichia coli, Virulence factor, Phylogenetic groups, Acute pyelonephritis

REFERENCES

1. Shaikh N, Morone NE, Bost IE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J. 2008; 27:302–8.

2. Roberts KB, Akintemi OB. The epidemiology and clinical presentation of urinary tract infections in children younger than 2 years of age. Pediatr Ann. 1999; 28:644–9.

3. Faust WC, Diaz M, Pohl HG. Incidence of post-pyeloneph-ritic renal scarring: a meta-analysis of the dimercapto-succinic acid literature. JUrol. 2009; 181:290–8.

4. Park YS. Renal scar formation after urinary tract infection in children. Korean JPediatr. 2012; 55:367–70.

5. Lee Y]. Lee JH, Park YS. Risk factors for renal scar formation in infants with first episode of acute pyelonephritis: a pro-spective clinical study. JUrol. 2012; 187:1032–6.

6. Pecile P, Miorin E, Romanello C, Vidal E, Contardo M, Valent F, et al. Age-related renal parenchymal lesions in children with first febrile urinary tract infections. Pediatrics. 2009; 124:23–9.

7. Jung HJ, Aum JA, Jung SJ, Huh JW. Different characteristic between Eschericbea coli and non-Escberjcbea 6011' urinary tract infection. Korean I Pediatr. 2007; 50:457–61.

8. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002; 113:5–13.

9. Bien J, Sokolova O, Bozko P. Role of uropathogenic Escherichia coli Virulence factors in development of urinary tract infection and kidney damage. Int J Nephrol 20122012681473.

10. Bonacorsi S, Houdouin V, Mariani-Kurkdjian P, Mahjoub-Messai F, Bingen E. Comparative prevalence of Virulence factors in Escherichia coli causing urinary tract infection in male infants with and without bacteremia. I Clin Microbiol. 2006; 44:1156–8.

11. Lee DG, Cho JJ, Park HK, Kim DK, Kim II, Chang SG, et al. Preventive effects of hyaluronic acid on Escherichia coli-in— duced urinary tract infection in rat. Urology. 2010; 75:949–54.

12. Chiou YY, Chen M], Chiu NT, Lin CY, Tseng CC. Bacterial Virulence factors are associated With occurrence of acute pyelonephritis but not renal scarring. J Urol. 2010; 184:2098–102.

13. Billips BK, Forrestal SG, Rycyk MT, Johnson IR, Klumpp DI, Schaeffer A}. Modulation of host innate immune response in the bladder by uropathogenic Escherichia coli. Infect Immun. 2007; 75:5353–60.

14. Schilling ID, Mulvey MA, Hultgren S]. Dynamic interactions between host and pathogen during acute urinary tract infec—tions. Urology. 2001; 57:56–61.

15. Song I, Abraham S. Innate and adaptive immune responses in the urinary tract. Eur I Clin Invest. 2008; 38:21–8.

16. Clermont O, Bonacorsi S, Bingen E. Rapid and simple deter—mination of the Escherichia coli phylogenetic group. Appl Environ Microbiol. 2000; 66:4555–8.

17. Tarchouna M, Ferjani A, Ben-Selma W, Boukadida I. Distribution of uropathogenic Virulence genes in Escherichia coli isolated from patients with urinary tract infection. Int I Infect Dis. 2013; 17:6450–3.

18. Newman TB, Bernzweig IA, Takayama II, Finch SA, Was-serman RC, Pantell RH. Urine testing and urinary tract infections in febrile infants seen in office settings: the Pediatric Research in Office Settings' Febrile Infant Study. Arch Pediatr Adolesc Med. 2002; 156:44–54.

19. Mak RH, Kuo H]. Pathogenesis of urinary tract infection: an update. Curr Opin Pediatr. 2006; 18:148–52.

20. Johnson IR, Owens K, Gajewski A, Kuskowski MA. Bacterial characteristics in relation to clinical source of Escherichia coli isolates from women with acute cystitis or pyelonephritis and uninfected women. I Clin Microbiol. 2005; 43:6064–72.

21. Tiba MR, Yano T, Leite Dda S. Genotypic characterization of virulence factors in Escherichia 6011' strains from patients with cystitis. Rev Inst Med Trop Sao Paulo. 2008; 50:255–60.

22. Houdouin V, Bonacorsi S, Mahjoub-Messai F, Mariani—Kurkdjian P, Bidet P, Sebag G, et al. Phylogenetic groups and Virulence factors of Escherichia coli strains causing pyelonephritis in children with and without urinary tract abnormalities. Clin Microbiol Infect. 2007; 13:740–2.

23. Brauner A, Jacobson SH, Kuhn I. Urinary Escherichia coli causing recurrent infections-a prospective follow-up of biochemical phenotypes. Clin Nephrol. 1992; 38:318–23.

24. Foxman B, Gillespie B, Koopman J, Zhang L, Palin K, Tallman P, et al. Risk factors for second urinary tract infection among college women. Am I Epidemiol. 2000; 151:1194–205.

25. Ik'alhelmo R, Siitonen A, Heiskanen T, Kérkkéiinen U, Kuos-manen P, Lipponen P, et al. Recurrence of urinary tract infection in a primary care setting: analysis of a 1-year follow-up of 179 women. Clin Infect Dis. 1996; 22:91–9.

Table 1.

Primers for the Polymerase Chain Reaction Assays

Target gene (s)	Name	Primer sequence (5'-3')	Size of Amplicon (bp)	Annealing temprature (°c)
Phylogenetic group
chuA	chuA-F	5'-GA(GAACFAACGGTFAGGAT-3'	279 bp	55°C
	chuA-R	5'-TGCCGCCAGTACCAAAGACA-3'
yjaA	yjaA-F	5'-TGAAGTGTCAGGAGACGCTG-3'	211 bp	55°C
	yjaA-R	5'-ATGGAGAATGCGTTCCTCAAC-3'
TspE4.C2	TspE4.C2-F	5'-GAGTAATGTCGGGGCATTCA-3'	152 bp	55^°C
	TspE4C2-R	5'-CGGCCAACAAAGTATTACG-3'
Virulence factors
fimH (Tpye 1 fimbriae)	fimH-F	5'-CFTGCTTATTTTGCACAGA-3'	300-400 bp	58^°C
	fimH-R	5'-TTGCCGTAATCCCAGACTC-3'
sfa (S family fimbriae)	sfa-F	5'-ATGGTTCACAGTACCGCACA-3'	300-400 bp	58°C
	sfa-R	5'-CACAGGGGCAGGGTAAAGTA-3'
padA (P family fimbriae)	papA-F	5'-CACAGGGGCAGGGTAAAGTA-3'	300-400 bp	58 “C
	papA-R	5'-CTGCCCCCTGAACTAGCATA-3'
hylA (Hemolysin A)	hylA-F	5'-AAACAGGTATTCGGCACAGC-3'	300-400 bp	58°C
	hylA-R	5'-CTGTGTCCACGAGTTGGTTG-3'
cnf(Cytotoxic necrotizinq factor I)	cnf-F	5'-ACTGGATGGGATCATCTTGG-3'	300-400 bp	58°C
	cnf-R	5'-CAFCFTFATFAAfZFTFTFFAT,2'

Table 2.

Phylogenetic Group Assignment of Escherichia coli

chuA	yjaA	TspE4.C2	Phylogenetic group assignment
-	-	-	A
-	+	-	A
-	-	+	B1
+	+	-	B2
+	+	+	B2
+	-	-	D
+	-	+	D

Table 3.

Clinical Characteristics and Phylogenetic Groups and Virulence Factors of Escherichia coli according to Clinica Diagnosis

	Acute ayelonephritis (N=26)	Cystitis (N=7)	P. value
Clinical Characteristics
Aqe (median and ranqe, month)	4 (0-49)	4(1-18)	0.739
Sex (male : female)	16:10	2:5	0.203
Patients with vesicoureteral reflux	10 (38.5%)	0(0.0%)	0.073
Phyloqenetic qroups and virulence factors
Phylogenetic group of E. coli
A	0(0.0%)	0(0.0%)	-
B1	0(0.0%	0(0.0%)	-
B2	24 (92.3%)	4(57.1%)	0.052
D	2 (7.7%)	3(42.9%)	0.052
Virulence fectors of F coli
fimH	26 (100.0%)	7(100.0%	-
sfa	26 (100.0%)	7(100.0%)	-
papA	9(34.6%	3(42.9%)	0.686
hV/A	17 (65.4%)	4(57.1%)	0.686
cnfl	17(65.4%)	4(57.1%)	0.686

Table 4.

Phylogenetic Group and Virulence Factors of Escherichia coli Causing Acute Pyelonephritis According to Accompanying Vesicoureteral Reflux

	No. (%) of isolates		P-value
	APN with VUR (N=10)	APN without VUR (N=16)	P-value
Phylogenetic group
A	0 (0.0%)	0 (0.0%)	-
B1	0 (0.0%)	0 (0.0%)	-
B2	9 (90.0%)	15 (93.8%)	1.000
D	1 (10.0%)	1 (6.2%)	1.000
Virulence factor
fimH	10 (100.0%)	16 (100.0%)	-
sfa	10 (100.0%)	16 (100.0%)	-
papA	2 (20.0%)	7 (43.8%)	0.399
hylA	7 (70.0%)	10 (62.5%)	1.000
cnfl	7(70.0%)	10 (61.5%)	1.000

Abbreviations: APN acute phelonephritis; VUR, vesicoureteral reflux.

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