title: Acute Escherichia coli prostatitis in previously health young men: bacterial virulence factors, antimicrobial resistance, and clinical outcomes.
abstract: OBJECTIVE
  To investigate clinical outcomes, bacterial virulence factors, and antimicrobial resistance in E. coli from young men presenting with acute bacterial prostatitis.
  
  
  METHODS
  Initial E. coli isolates from previously healthy young men with no factors compromising urinary tract anatomy or function were tested for virulence-associated genes by polymerase chain reaction (PCR) assays, phylogenetic grouping by triplex polymerase PCR, and antibiotic resistance.
  
  
  RESULTS
  All 18 patients responded to treatment, including 2 who required long-term therapy. E. coli were allocated to phylogenetic groups B2 (13 strains) and D (5 strains). Prostatitis isolates belonged to clones mainly represented by extraintestinal pathogenic E. coli (ExPEC) and preferentially uropathogenic E. coli and displayed marked accumulation of virulence genes (hly, cdt1, clb, pap, sfa/foc, fyuA, iroN, kpsMT(II), and traT) characteristic of highly virulent ExPEC. All phylogenetic group B2 strains coded for at least 1 toxin with carcinogenic potential (Colibactin, cytolethal distending toxins, or cytotoxic necrotizing factor). In contrast to their accumulation of virulence-associated traits, prostatitis strains were sensitive to standard antibiotics.
  
  
  CONCLUSIONS
  The phylogenetic background and accumulation of an exceptional repertoire of extraintestinal pathogenic virulence-associated genes indicate that these E. coli strains belong to a highly virulent subset of uropathogenic variants. In contrast, antibiotic resistance was minimal in these E. coli strains from previously healthy, young outpatients.
authors: University of Washington School of Medicine, Seattle, WA 98108-1597, USA. jkrieger@uw.edu
authors: John N
authors: JN
authors: Krieger
authors: Ulrich
authors: U
authors: Dobrindt
authors: Donald E
authors: DE
authors: Riley
authors: Eric
authors: E
authors: Oswald
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D004352:Drug Resistance, Microbial; D004926:Escherichia coli / Q000378:metabolism*; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000382:microbiology*; D005838:Genotype; D006801:Humans; D008297:Male; D010641:Phenotype; D011472:Prostatitis / Q000175:diagnosis* / Q000382:microbiology*; D016896:Treatment Outcome; D014551:Urinary Tract / Q000382:microbiology; D014774:Virulence; D037521:Virulence Factors / Q000378:metabolism
chemical_list: D037521:Virulence Factors