title: Recurrent urinary tract infections in infancy: relapses or reinfections?
abstract: Seventeen infants with an index episode of pyelonephritis caused by Escherichia coli were monitored for 18 months for recurrent urinary tract infections (UTIs). All the infants had at least 1 recurrent UTI caused by the same pathogen. Twenty-six recurrent UTI episodes were recorded. The 40 E. coli strains available were analyzed by multiplex polymerase chain reaction for 3 alleles (classes I-III) of the papG gene and by pulsed-field gel electrophoresis (PFGE) after genomial digestion by XbaI. Of the 17 index strains, 12 (71%) carried the papG gene; 67% of these strains had class II alleles. In recurrent UTI isolates, the papG-positive E. coli appeared in 16 (70%) of 23 isolates. The proportion of all recurrent isolates available that represented a strain previously encountered (indistinguishable or highly similar in PFGE) in the same infant was 65%. Our results suggest that most recurrent UTIs in infants are endogenous relapses rather than reinfections caused by new organisms.
authors.affiliation: Hospital for Children and Adolescents, University of Helsinki, Finland. maria.jantunen@ktl.fi
authors.forename: M E
authors.initials: ME
authors.lastname: Jantunen
authors.forename: H
authors.initials: H
authors.lastname: Saxén
authors.forename: E
authors.initials: E
authors.lastname: Salo
authors.forename: A
authors.initials: A
authors.lastname: Siitonen
mesh_terms: D018830:Adhesins, Escherichia coli / Q000235:genetics; D002675:Child, Preschool; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000235:genetics; D005260:Female; D036781:Fimbriae Proteins; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology*
chemical_list: D018830:Adhesins, Escherichia coli; C092426:PapG protein, E coli; D036781:Fimbriae Proteins