In recurrent uncomplicated lower urinary tract infections (uLUTI) bacteriuria below 103 CFU/ml is usually not investigated.
Molecular-genetic characteristics of the pathogenic potential of Enterobacteriaceae isolated during the inter-episode period of recurrent uLUTI at bacteriuria of 102 CFU/ml.
Midstream urine samples taken from 169 women with recurrent uLUTI between episodes were examined on six media. 15 Enterobacteriaceae strains at low level bacteriuria (102 CFU/ml) were analyzed (PCR) for the presence of virulence factor (VFG) genes: papA; papE/F; papGII; afa; bmaE; iutA; feoB; fyuA; kpsMTII; usp.
All 169 patients had leukocyturia and asymptomatic bacteriuria, 62 of them due to enterobacteria: 102 CFU/ml - 15(24.2%), 103 CFU/ml - 10(16.1%), > 103 CFU/ml - 37(59.7%). In all 15 strains at low level bacteriuria (102 CFU/ml) VFG were verified: 1 VFG (papGII) was found in 2 strains of Klebsiella (13.3%), 3 VFG in 1 strain of Enterobacter (16.7%), from 4 to 9 VFG together - the remaining 12 strains. Among the VFGs, papGII (93.3%), usp (86.7%), feoB, fyuA (80.0% each) and kpsMTII (73.3%) predominated. A significant correlation was found between the presence of papE (p = 0.02), usp (p = 0.025) and a relapse rate of more than 4. Leukocyturia is associated with the presence of VFG papE (p = 0.031) and papGII (p = 0.031).
Enterobacteria isolated from urine of female patients with recurrent uLUTI at bacteriuria level of 102 CFU/ml have a wide spectrum of VFG, which may play a role in maintaining chronic lower urinary tract inflammation.
International journal of antimicrobial agents. 2020 Apr 21 [Epub ahead of print]
Yulia L Naboka, Ayrat R Mavzyiutov, Michel I Kogan, Irina A Gudima, Sergey N Ivanov, Kurt G Naber
Department of Microbiology No. 1, Rostov State Medical University Hospital, Rostov-on-Don, Russia. Electronic address: ., Department of Fundamental and Applied Microbiology, Bashkir State Medical University, Ufa, Russia. Electronic address: ., Department of Urology, Rostov State Medical University Hospital, Rostov-on-Don, Russia. Electronic address: ., Department of Microbiology No. 1, Rostov State Medical University Hospital, Rostov-on-Don, Russia. Electronic address: ., Department of Urology, Rostov State Medical University Hospital, Rostov-on-Don, Russia. Electronic address: ., Department of Urology, Technical University of Munich, Munich, Germany. Electronic address: .