title: Virulence determinants, phylogenetic groups and fluoroquinolone resistance in Escherichia coli isolated from cystitis and pyelonephritis.
abstract: OBJECTIVE
  The aim of this study is to assess the relation between virulence genotype, phylogenetic group and susceptibility to fluoroquinolones and the urinary tract infection type including pyelonephritis and cystitis due to Escherichia coli.
  
  
  METHODS
  Between 2006 and 2007, 129 non-duplicate E. coli isolates from pyelonephritis (n=56) and cystitis (n=73) were prospectively collected. The antibiotic susceptibility was done by disk diffusion method. The phylogenetic groups, A, B1, B2 and D and 18 virulence genes were determined by multiplex PCR. Statistical analysis was done with the Pearson χ2 test, Mann-Whitney U-test, Kruskal-Wallis test and stepwise multivariable logistic regression analysis, P values below 0.05 were considered statistically significant.
  
  
  RESULTS
  For the pyelonephritis group, sex ratio was 0.3, the median age for women was 30 years and for men it was 54 years. For the cystitis group, sex ratio was 0.4, the median age for women was 41.5 years and for men it was 67.8 years. Significant statistical correlations were found between pyelonephritis isolates and susceptibility to ciprofloxacin (P=4 10(-5)), papG allele II (P=2 10(-6)), hlyA (P=10(-03)), iroN (P=0.04), iha (P=0.03) and ompT (P=0.03) virulence genes, high virulence score (P=0.008) and B2 phylogenetic group (P=0.03). In multivariate logistic regression analysis, papG II as predictor of pyelonephritis, no correlation could be established for the cystitis group.
  
  
  CONCLUSIONS
  Our findings argue for a direct link between pyelonephritis, virulence factors, susceptibility to fluroquinolones and B2 phylogenetic group among uropthogenic E. coli.
authors.affiliation: Laboratoire de recherche resistance aux antimicrobiens, hôpital Charles-Nicolle de Tunis, boulevard 9-Avril, 1006 Tunis, Tunisia. ferjsana@yahoo.fr
authors.forename: S
authors.initials: S
authors.lastname: Ferjani
authors.forename: M
authors.initials: M
authors.lastname: Saidani
authors.forename: S
authors.initials: S
authors.lastname: Ennigrou
authors.forename: M
authors.initials: M
authors.lastname: Hsairi
authors.forename: S
authors.initials: S
authors.lastname: Ben Redjeb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D011704:Pyelonephritis / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology; D037521:Virulence Factors / Q000032:analysis / Q000235:genetics*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D037521:Virulence Factors