The gene profile of Enterobacteriaceae virulence factors in relation to bacteriuria levels between the acute episodes of recurrent uncomplicated lower urinary tract infection

ABSTRACT

Objectives

The pathogenic potential of uropathogens isolated between acute episodes of recurrent lower urinary tract infection (rLUTI) is studied insufficiently. The objectives were to determine the spectrum of virulence genes of Enterobacteriaceae cultured between acute episodes of rLUTI at various levels of bacteriuria.

Methods

Bacteriological examinations of 169 premenopausal women’s midstream urine with rLUTI were performed between acute episodes of UTI. Sixty-two strains of Enterobacteriaceae at concentrations 10²–10⁸ CFU/ml were analyzed for the presence of papA, papE/F, papGII, afa, bmaE, iutA, feoB, fyuA, kpsMTII, and usp virulence factors genes’ (VFGs) fragments.

Results

In all strains VFGs were found with numbers from 1 to 10. Four VFGs were found at all levels of bacteriuria (from 10² to 10⁷⁻⁸) in most strains (>50%): papGII, feoB, fyuA, usp. In total, 28 significant Pearson contingency coefficient (PCC) were determined. Each of the genes, papA, papE/F, usp, was found more often in uropathogens from patients with a higher level of leukocyturia.

Conclusions

The inter-episode period in rLUTI is associated with varying levels of bacteriuria of enterobacteria. Since enterobacteria virulent potential could be determined at all levels of bacteriuria, there is at all levels of bacteriuria a potential risk for recurrence of LUTI.

KEYWORDS:

• Recurrent urinary tract infection
• bacteriuria
• virulence factor genes
• enterobacteriaceae
• uropathogenic Escherichia coli

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

KGN was involved in the discussing and reviewing of the manuscript and suggesting corrections and improvements. ARM was involved in the performance and analysis of genetic studies. MIK was involved in the collection of clinical specimens and the writing of the manuscript. IAG was involved in the bacteriological research. KTD was performed the statistical data analysis. SNI was involved with the reviewing of the literature related to the topic.

Additional information

Funding

The study was funded by the Rostov State Medical University Hospital, Rostov-on-Don, Russia.