Determination of phenotypic expression of the fimbriae and hemolysin of uropathogenic Escherichia coli (UPEC)

Sabitha Baby, Vimal Kumar Karnaker, Geetha RK

Abstract


Background: The bacterial strains that cause symptomatic urinary tract infections possess diverse distinctive properties that enable them to overcome the local host defences. In Escherichia coli, virulence results from the cumulative impact of several virulence factors, which can vary according to the patient populations. The study was undertaken to assess the prevalence of the virulence factors by phenotypic assays in the E. coli isolates which were isolated from patients with UTI from a tertiary care hospital in Kerala.

Methods: A total of 300 E. coli isolates were obtained from symptomatic cases of urinary tract infections and 30 E. coli faecal isolates were obtained from apparently healthy individuals and they were tested for phenotypic properties like haemolysin production, mannose resistant hemagglutination to indicate P fimbriae, cell surface hydrophobicity.

Results: Among the 300 E. coli isolates from the cases group, 135 (43.5%) were hemolytic, 106 (35.5%) were MRHA positive, 123 (41%) were hydrophobic. Among the 30 controls, 2 (6%) were hemolytic, 02 (6%) were MRHA positive and 04 (10%) were hydrophobic. The difference between the cases and the control group was significant (P <0.001). Multiple virulence factors were observed in 51% of the isolates.

Conclusion: The present study showed varied phenotypic expression of the virulence factors in the urinary isolates as compared to the fecal isolates.


Keywords


UTI, Escherichia coli, Virulence factors, Phenotypic, Hemolysin, Hemagglutination, Serum resistance, Hydrophobicity, Adhesions

Full Text:

PDF

References


Rebecca N, Elizabeth M. Some virulence characteristics of the uropathogenic Escherichia coli in different patient groups. Indian J Med Res. 2005;122:143-7.

Vgaarali MA, Karadesai SG, Patil CS, Metgud SC, Mutnal MB. Hemagglutination and siderophore production as the urovirulence markers of the uropathogenic Escherichia coli. Indian J Med Microbiol. 2008;26(1):68-70.

Forbes BA, Sham DF, Weissfeld AS. Infections of the urinary tract. In: Forbes BA, Sham DF, Weissfeld AS, eds. Bailey and Scott’s Diagnostic Microbiology. 12th ed. St. Louis: Mosby Elsevier; 2007: 842-855.

Johnson JR. The microbial virulence determinants and the pathogenesis of urinary tract infections. Infect Dis Clin N Am. 2003;17:261-78.

Oelschlaeger TA, Dobrindt U, Hacker J. The virulence factors of the uropathogens. Curr Opin Urol. 2002;12(1):33-8.

Sobel JD, Kaye D. Urinary tract infections. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s Principals And Practice Of Infectious Diseases. 5th ed. New York, NY: Churchill Livingstone; 2000: 773-805.

Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for the antimicrobial therapy of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Infectious Diseases Society of America (IDSA). Clin Infect Dis. 1999;29:745-58.

Mandal P, Kapil A, Goswami K, Das B, Dwivedi SN. The uropathogenic Escherichia coli cause urinary tract infections. Indian J Med Res. 2001;114:207-11.

Johnson JR. The virulence factors in the Escherichia coli which were isolated from urinary tract infections. Clin Microbiol Rev. 1991;4(1):80-128.

Sharma S, Bhat GK, Shenoy S. The virulence factors and the drug resistance in the Escherichia coli which were isolated from extraintestinal infections. Indian J Med Microbiol. 2007;25(4):369-73.

Yasmeen K, Sneha KC, Shobha DN, Halesh LH, Chandrasekhar MR. The virulence factors, serotypes and the antimicrobial susceptibility pattern of Escherichia coli in urinary tract infections. Al Ameen J Med Sci. 2009;2(1):47-51.

Raksha R, Srinivasa H, Macaden RS. The occurrence and the characterization of the uropathogenic Escherichia coli in urinary tract infections. Indian J Med Microbiol. 2003;21(2):102-7.

Sussman M. Urinary tract infections. In: Collier L, Balows A, Sussman M, eds. Topley and Wilson’s Microbiology and Microbial Infections. 9th ed. Great Britain: Arnold; 1998: 601-621.

Tom C, Henry R. Escherichia. In: Collier L, Balows A, eds. Topley and Wilson's Microbiology and Microbial Infections. 9th ed. Arnold: Great Britain; 1998: 507-521.

Ikäheimo R, Siitonen A, Kärkkäinen U, Mäkelä PH. The virulence characteristics of the Escherichia coli which cause nosocomial urinary tract infections. Clin Infect Dis. 1993;16(6):785-91.

Foxman B, Brown P. The epidemiology of the urinary tract infections, the transmission and risk factors, incidence, and the costs. Infect Dis Clin N Am. 2003;17:227-41.

Brauner A, Boeufgras JM, Jacobson SH, Kaijser B, Källenius G, Svenson SB et al. The use of biochemical markers, serotypes and fimbriation for the detection of the Escherichia coli clones. J Gen Microbiol. 1987;133(10):2825-34.

Srikanth NS, Macaden R. The uropathogenic Escherichia coli: a preliminary study. Indian J Pathol Microbiol. 2003;46(1):145-6.

Duguid JP, Clegg S, Wilson M.I. The fimbrial and the non-fimbrial hemagglutinins of Escherichia coli. J Med Microbiol. 1979;12:213-28.

Seigfried L, Kmetova M, Puzova H, Molokacova M, Filka J. The virulence associated factors in the Escherichia coli strains which were isolated from children with urinary tract infections. J Med Microbiol. 1994;41:127-52.

Gholamhoseinian NA, Mosavi NM, Mansouri S. The comparison between the virulence factors of Escherichia coli, which were isolated from urinary tract infections and from the faecal flora. Res Pharmaceut Sci. 2007;2:99-103.

Gupta V, Yadav A, Joshi RM. The antibiotic resistance pattern in the uropathogens. Indian J Med Microbiol. 2002;20:96-8.

Taylor P W. Bactericidal and bacteriolytic activity of serum against gram negative bacteria. Microbiol Rev. 1983:47:46-83.

Connie R Mahon, Donald C Lehman, George Manuselis. Urinary Tract Infections. In: Connie R Mahon, George Manuselis Jr, eds. Text book of Diagnostic Microbiology: 3rd. Philadelphia: Saunders Elsiever Publications; 2007: 1011-1129.