Association between mannose-binding lectin deficiency and septic shock following acute pyelonephritis due to Escherichia coli.
Structural and promoter MBL2 gene polymorphisms responsible for low MBL levels are associated with increased risk of infection. The objective of this study was to assess the possible association between polymorphisms of the MBL2 gene and the incidence of septic shock and bacteremia in patients with acute pyelonephritis due to Escherichia coli. The study included 62 female patients with acute pyelonephritis due to E. coli who required hospital admission, as well as 133 healthy control subjects. Six single-nucleotide polymorphisms (-550 G/C, -221 C/G, +4 C/T, codon 52 CGT/TGT, codon 54 GGC/GAC, and codon 57 GGA/GAA) in the MBL2 gene were genotyped by using a sequence-based typing technique. No significant differences were observed in the frequencies for low-expression MBL2 genotypes (O/O and LXA/O) between patients with acute pyelonephritis and healthy controls. Patients with acute pyelonephritis and septic shock had a higher incidence of low-expression MBL2 genotypes than patients with acute pyelonephritis without septic shock (odds ratio = 9.019, 95% confidence interval = 1.23 to 65.93; P = 0.03). No association was found between bacteremic acute pyelonephritis and low-expression MBL2 genotypes. We found that low-expression MBL2 genotypes predispose to septic shock but not to bacteremia in patients with E. coli-induced acute pyelonephritis. Determination of MBL2 polymorphisms could be useful for assessing the risk of septic shock in women undergoing acute pyelonephritis.
Smithson
Alex
A
Infectious Diseases Unit, Hospital Clínic, IDIBAPS, Edificio Helios, 1 Planta C/Villarroel 170, 08036 Barcelona, Spain. asa30412@hotmail.com
Muñoz
Ana
A
Suarez
Belen
B
Soto
Sara Maria
SM
Perello
Rafael
R
Soriano
Alex
A
Martinez
Jose Antonio
JA
Vila
Jordi
J
Horcajada
Juan Pablo
JP
Mensa
Jose
J
Lozano
Francisco
F
D000208:Acute Disease; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000209:etiology / Q000235:genetics; D004927:Escherichia coli Infections / Q000209:etiology* / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D037601:Mannose-Binding Lectin / Q000172:deficiency / Q000235:genetics*; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D011704:Pyelonephritis / Q000209:etiology* / Q000235:genetics; D012772:Shock, Septic / Q000209:etiology* / Q000235:genetics
D037601:Mannose-Binding Lectin