This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Johnson, J. R. Articles by Sandberg, T. Search for Related Content PubMed PubMed Citation Articles by Johnson, J. R. Articles by Sandberg, T.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, August 2005, p. 3895-3900, Vol. 43, No. 8
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.8.3895-3900.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Phylogenetic and Pathotypic Comparison of Concurrent Urine and Rectal Escherichia coli Isolates from Men with Febrile Urinary Tract Infection

Mucosal and Vaccine Research Center,¹ Geriatric Research, Education, and Clinical Center, Minneapolis VA Medical Center,⁵ Departments of Medicine,² Psychiatry, University of Minnesota, Minneapolis, Minnesota,⁶ International Escherichia coli and Klebsiella Center, Statens Seruminstitut, Copenhagen, Denmark,³ Department of Infectious Diseases, University of Göteborg, Göteborg, Sweden⁴

Received 27 February 2005/ Returned for modification 11 April 2005/ Accepted 18 May 2005

Among men with febrile urinary tract infection (FUTI), whether the host's fecal flora is the source for the urine strain ("fecal-urethral" hypothesis), and whether pathogenesis is driven by prevalence versus special pathogenicity, are unknown. Accordingly, pretherapy urine isolates from 65 men with FUTI were compared with concurrent rectal isolates from the same hosts according to serotype, genomic profile, phylogenetic group, and virulence genotype. The host's multiple rectal colonies included only the urine clone in 25% of subjects, the urine clone plus additional clones in 22%, and only nonurine clones in 54%. Compared with the 67 unique rectal clones, the 65 urine isolates were significantly enriched for phylogenetic group B2, virulence-associated serotypes, and specific virulence genes and contained more virulence genes (median, 10 versus 6: P < 0.001). In multivariable models, phylogenetic group B2, hlyD (hemolysin), cnf1 (cytotoxic necrotizing factor), iroN (siderophore receptor), ompT (outer membrane protease), and malX (pathogenicity island marker) most strongly predicted urine source. These findings challenge the fecal-urethral and prevalence hypotheses for FUTI pathogenesis and instead strongly support the possibility of alternate infection routes in some men and the special pathogenicity hypothesis. They also identify specific bacterial traits as potential targets for anti-FUTI interventions.

This article has been cited by other articles:

• Rodriguez-Bano, J., Lopez-Cerero, L., Navarro, M. D., de Alba, P. D., Pascual, A. (2008). Faecal carriage of extended-spectrum {beta}-lactamase-producing Escherichia coli: prevalence, risk factors and molecular epidemiology. J Antimicrob Chemother 62: 1142-1149 [Abstract] [Full Text]  
• Moreno, E., Andreu, A., Pigrau, C., Kuskowski, M. A., Johnson, J. R., Prats, G. (2008). Relationship between Escherichia coli Strains Causing Acute Cystitis in Women and the Fecal E. coli Population of the Host. J. Clin. Microbiol. 46: 2529-2534 [Abstract] [Full Text]  
• Bronowski, C., Smith, S. L., Yokota, K., Corkill, J. E., Martin, H. M., Campbell, B. J., Rhodes, J. M., Hart, C. A., Winstanley, C. (2008). A subset of mucosa-associated Escherichia coli isolates from patients with colon cancer, but not Crohn's disease, share pathogenicity islands with urinary pathogenic E. coli. Microbiology 154: 571-583 [Abstract] [Full Text]  
• Feldmann, F., Sorsa, L. J., Hildinger, K., Schubert, S. (2007). The Salmochelin Siderophore Receptor IroN Contributes to Invasion of Urothelial Cells by Extraintestinal Pathogenic Escherichia coli In Vitro. Infect. Immun. 75: 3183-3187 [Abstract] [Full Text]  
• Fischbach, M. A., Lin, H., Zhou, L., Yu, Y., Abergel, R. J., Liu, D. R., Raymond, K. N., Wanner, B. L., Strong, R. K., Walsh, C. T., Aderem, A., Smith, K. D. (2006). The pathogen-associated iroA gene cluster mediates bacterial evasion of lipocalin 2. Proc. Natl. Acad. Sci. USA 103: 16502-16507 [Abstract] [Full Text]  
• Davis, J. M., Carvalho, H. M., Rasmussen, S. B., O'Brien, A. D. (2006). Cytotoxic Necrotizing Factor Type 1 Delivered by Outer Membrane Vesicles of Uropathogenic Escherichia coli Attenuates Polymorphonuclear Leukocyte Antimicrobial Activity and Chemotaxis.. Infect. Immun. 74: 4401-4408 [Abstract] [Full Text]  
• Johnson, J. R., Owens, K., Gajewski, A., Kuskowski, M. A. (2005). Bacterial Characteristics in Relation to Clinical Source of Escherichia coli Isolates from Women with Acute Cystitis or Pyelonephritis and Uninfected Women. J. Clin. Microbiol. 43: 6064-6072 [Abstract] [Full Text]