title: Prevalence of virulence factors and phylogenetic characterization of uropathogenic Escherichia coli causing urinary tract infection in patients with and without diabetes mellitus.
abstract: BACKGROUND
  We aimed to determine the virulence factor profile and phylogenetic grouping of uropathogenic Escherichia coli (UPEC) causing urinary tract infection (UTI) in patients with and without diabetes mellitus (DM).
  
  
  METHODS
  A total of 280 UPEC were collected from the urine samples of patients with DM (n=126) and patients suffering from non-DM UTIs (n=154). All isolates were subjected to phenotypic and genotypic virulence factor profile and phylogenetic grouping.
  
  
  RESULTS
  There was no significant difference in phenotypic virulence factors of UPEC causing UTI from patients with and without DM; alpha-haemolysin (DM=52, 41.2%; non-DM=69, 44.8%), mannose resistant haemagglutination (DM=6, 36.2%; non-DM=64, 41.5%), biofilm production (DM=33.3%; non-DM=25.9%), serum resistance (DM=27, 21.4%; non-DM=46, 29.8%), cell surface hydrophobicity (DM=22, 17.1%; non-DM=18, 11.6%) and mannose sensitive hemagglutnation (DM=18, 14.2%; non-DM=29, 18.8%). Among the genotypic virulence markers, papC gene was most prevalent in both patients with DM (n=65, 51.6%) and without DM (n=88, 57.1%), followed by hlyD gene (DM=36, 28.6%; non-DM=52, 33.8%). Only cnf-1 gene was observed to be significantly associated (p<0.05) with the non-DM status (n=35, 22.7%) than DM (n=15, 11.9%). Irrespective of the diabetic status, majority of the UPEC isolates (approximately 50%) belonged to phylogenetic group B2 predominantly harboring the virulence genes papC, hlyD and cnf-1.
  
  
  CONCLUSIONS
  This study demonstrates that there may not be a differential selection of virulence properties of UPEC causing UTI in patients with DM and in the general population.
authors.affiliation: Department of Microbiology, Navodaya Medical College, Raichur, Karnataka, India anandkumar.harwalkar@gmail.com.
authors.forename: Anandkumar
authors.initials: A
authors.lastname: Harwalkar
authors.affiliation: Department of Microbiology, St. John's Medical College, Bangalore, Karnataka, India.
authors.forename: Soham
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Microbiology, Navodaya Medical College, Raichur, Karnataka, India.
authors.forename: Achyut
authors.initials: A
authors.lastname: Rao
authors.affiliation: Department of Microbiology, St. John's Medical College, Bangalore, Karnataka, India.
authors.forename: Hiresave
authors.initials: H
authors.lastname: Srinivasa
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D018441:Biofilms / Q000254:growth & development; D003920:Diabetes Mellitus / Q000382:microbiology*; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D014552:Urinary Tract Infections / Q000382:microbiology*; D056689:Uropathogenic Escherichia coli / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity*; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D037521:Virulence Factors
keywords: India; Phylogenetic characterization; Urinary tract infections; Uropathogenic Escherichia coli; Urovirulence genes