title: Detection of virulence genes in Escherichia coli isolated from patients with cystitis and pyelonephritis.
abstract: BACKGROUND
  Uropathogenic Escherichia coli (UPEC) is a common cause of ascending urinary tract infections including cystitis and pyelonephritis. The purpose of this study was to investigate virulence genes among Escherichia coli isolated from patients with cystitis and pyelonephritis.
  
  
  METHODS
  Between December 2012 and June 2013, 150 E. coli isolates from hospitalized patients with pyelonephritis (n = 72) and cystitis (n=78) were collected at Shahid Beheshti Hospital in Kashan. A PCR assay was used to evaluate the presence of virulence genes including pap, hly, aer, sfa, cnf, afa, traT, and pathogenicity island (PAI) markers in isolates.
  
  
  RESULTS
  Of the total 150 UPEC isolates, 130 (86.7%) were found to carry the virulence genes studied. Nineteen different virulence patterns were identified. The most prevalent virulence pattern was UPEC including traT-PAI operons. The pap, traT, aer, hly, and PAI operons were more prevalent among patients with pyelonephritis than cystitis, and the sfa, afa, and cnf genes were not detected in any of the isolates.
  
  
  CONCLUSIONS
  Higher virulence gene diversity was found among pyelonephritis UPEC isolates in comparison to cystitis UPEC isolates, showing that UPEC strains that cause pyelonephritis need more virulence factors.
authors.affiliation: Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, PO Box 87159-88141, Kashan, I.R. Iran. Electronic address: ffiroozeh@ut.ac.ir.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Firoozeh
authors.affiliation: Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, PO Box 87159-88141, Kashan, I.R. Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Saffari
authors.affiliation: Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, PO Box 87159-88141, Kashan, I.R. Iran.
authors.forename: Foroogh
authors.initials: F
authors.lastname: Neamati
authors.affiliation: Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, Karaj, I.R. Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zibaei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003556:Cystitis / Q000382:microbiology*; D004926:Escherichia coli / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000382:microbiology*; D005260:Female; D014644:Genetic Variation; D044404:Genomic Islands; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011704:Pyelonephritis / Q000382:microbiology*; D014774:Virulence / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D037521:Virulence Factors
keywords: Cystitis; Pyelonephritis; Uropathogenic Escherichia coli; Virulence genes