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15 March 2005

Volume 40, Number 6
Clinical Infectious Diseases 2005;40:813–822
© 2005 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2005/4006-0007$15.00
DOI: 10.1086/428048
MAJOR ARTICLE

Host‐Pathogen Relationships among Escherichia coli Isolates Recovered from Men with Febrile Urinary Tract Infection

James R. Johnson,1,3

Flemming Scheutz,5

Peter Ulleryd,6

Michael A. Kuskowski,2,4

Timothy T. O’Bryan,1,3,a and

Torsten Sandberg6

1Mucosal and Vaccine Research Center and 2Geriatric Research, Education, and Clinical Center, Minneapolis Veterans Affairs Medical Center, and Departments of 3Medicine and 4Psychiatry, University of Minnesota, Minneapolis; 5International Escherichia coli and Klebsiella Center, World Health Organization, Statens Seruminstitut, Copenhagen, Denmark; and 6Departments of Infectious Diseases, University of Göteborg, Göteborg, Sweden

Background.Host‐pathogen relationships in men with febrile urinary tract infection (FUTI) are poorly understood.

Methods.Phylogenetic background, extended virulence genotypes, and serotypes were determined for 70 Escherichia coli isolates recovered from urine samples obtained from men with FUTI for comparison with available data for 70 E. coli rectal isolates recovered from uninfected men. Bacterial traits were assessed in relation to underlying host characteristics (age, compromise status, and history of urinary tract infection) and acute manifestations (bacteremia, flank pain, and serum prostate‐specific antigen [PSA] level).

Results.Compared with rectal isolates, FUTI isolates exhibited a significantly higher prevalence of virulence‐associated phylogenetic groups, serotypes, and extraintestinal virulence genes. The latter included traditional prostatitis‐associated traits (e.g., hemolysin and cytotoxic necrotizing factor), as well as unconventional traits, such as outer membrane protease T. These bacterial traits occurred largely independent of host age, urological compromise status, urinary tract infection history, and acute manifestations. However, certain traits were less prevalent in association with use of urinary tract instrumentation and significantly predicted elevated PSA levels.

Conclusions.Considerable virulence capability may be required for an E. coli strain to cause FUTI in men, regardless of whether most compromising conditions are present. Bacterial traits that promote prostatic invasion may be relevant for the pathogenesis of FUTI, even among men without classic manifestations of acute prostatitis.

Received 9 September 2004; accepted 4 November 2004; electronically published 16 February 2005.

Reprints or correspondence: Dr. James R. Johnson, Infectious Diseases (111F), Minneapolis VA Medical Center, 1 Veterans Dr., Minneapolis, MN 55417 ().

Cited by

M.-C. Wang, C.-C. Tseng, A.-B. Wu, J.-J. Huang, B.-S. Sheu, J.-J. Wu. (2009) Different roles of host and bacterial factors in Escherichia coli extra-intestinal infections. Clinical Microbiology and Infection 15:4, 372-379
Online publication date: 1-May-2009.
CrossRef
Hee Jung Coe, Tae Hyung Kim, Hyuk Cho, Ji Hong Kim. (2007) Comparison of the Clinical and Radiologic Characteristics between Different Age Groups with First Febrile UTI Under 2 Years of Age. Journal of the Korean Society of Pediatric Nephrology 11:2, 229
Online publication date: 1-Feb-2007.
CrossRef

  • Present affiliation: Gentra Systems, Minneapolis, Minnesota.

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