Virulence-associated traits in Escherichia coli causing first and recurrent episodes of urinary tract infection in children with or without vesicoureteral reflux.
Virulence-associated traits in Escherichia coli causing first and recurrent episodes of urinary tract infection in children with or without vesicoureteral reflux.
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大肠杆菌的毒力相关特征导致患有或不患有膀胱输尿管反流的儿童首次和复发性尿路感染。
DOI：
10.1093/infdis/150.4.561
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
C. Svanborg Edén
中科院分区：
文献类型：
--
作者：
H. Lomberg;M. Hellström;U. Jodal;H. Leffler;K. Lincoln;C. Svanborg Edén
174例尿路感染患儿的606株尿路分离株的毒力相关特性与感染的严重程度和增加宿主易感性的因素有关，例如膀胱输尿管返流(II级或更高)和P1血型。在无反流的儿童中，引起首次或反复发作急性肾盂肾炎的大肠杆菌菌株比例很高，表现出先前提到的某些O抗原的高频率、对血清杀伤的抵抗力、溶血素的产生和黏附能力。这些性状的频率显著降低，而非E基因频率显著升高。在肾盂肾炎和反流、膀胱炎和无症状菌尿的儿童分离株中发现了大肠埃希菌。因此，反流被发现是感染程度和产生肾盂肾炎所需细菌特性的决定因素。通过干扰“毒力”细菌来预防或治疗尿路感染的努力，对于最有可能形成肾疤痕的复发性肾盂肾炎和反流患者来说，可能没有那么大的价值。
Virulence-associated properties of 606 urinary isolates from 174 children with urinary tract infections were related to severity of infection and factors increasing host susceptibility, e.g., vesicoureteral reflux (grade II or higher) and P1 blood group phenotype. A high proportion of strains of Escherichia coli causing first or recurrent episodes of acute pyelonephritis in children without reflux expressed the previously noted high frequency of certain O antigens, resistance to serum killing, hemolysin production, and adhesive capacity. A significantly lower frequency of these traits and a higher frequency of non-E. coli were seen among isolates from children with pyelonephritis and reflux, cystitis, and asymptomatic bacteriuria. Reflux was thus found to be a determinant of the level of infection and of the bacterial properties required to produce pyelonephritis. Efforts aimed at preventing or treating urinary tract infection by interfering with "virulent" bacteria may be of less value in patients with recurrent pyelonephritis and reflux, who are most likely to develop renal scars.