title: Bacterial characteristics and glycemic control in diabetic patients with Escherichia coli urinary tract infection.
abstract: BACKGROUND
  Patients with diabetes mellitus have an increased risk of infection. The roles of bacterial characteristics and glycemic control in diabetic patients with Escherichia coli infection have not been well investigated. The aims of this study were to examine the bacterial characteristics and glycemic control in diabetic patients with E. coli infections arising in the urinary tract.
  
  
  METHODS
  A total of 271 E. coli isolates were collected from urine and bloodstream. Phylogenetic groups, the presence of virulence genes, and antimicrobial susceptibility of E. coli isolates were determined.
  
  
  RESULTS
  There were few differences in E. coli bacterial characteristics between 190 diabetic and 81 nondiabetic patients. In diabetic patients with urosepsis, there was a higher hemoglobin A(1C) level, and the related E. coli strains had more neuA, papG II, afa and hlyA genes, and a lower prevalence of antimicrobial resistance to cephalosporins and fluoroquinolones than those with asymptomatic bacteriuria and urinary tract infection. Multivariate logistic regression analysis revealed that increased hemoglobin A(1C) and presence of papG II and afa genes were independent factors associated with development of urosepsis in diabetic patients.
  
  
  CONCLUSIONS
  This study demonstrated that more virulent E. coli isolates, especially with papG II and afa genes, and poorer glycemic control were important determinants for development of urosepsis in diabetic patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Wang
authors.forename: Chin-Chung
authors.initials: CC
authors.lastname: Tseng
authors.forename: An-Bang
authors.initials: AB
authors.lastname: Wu
authors.forename: Wei-Hung
authors.initials: WH
authors.lastname: Lin
authors.forename: Ching-Hao
authors.initials: CH
authors.lastname: Teng
authors.forename: Jing-Jou
authors.initials: JJ
authors.lastname: Yan
authors.forename: Jiunn-Jong
authors.initials: JJ
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001769:Blood / Q000382:microbiology; D001786:Blood Glucose; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000473:pathology / Q000628:therapy*; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000382:microbiology*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000382:microbiology*; D014556:Urine / Q000382:microbiology; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001786:Blood Glucose; D037521:Virulence Factors