1887

Abstract

is the most common pathogen causing acute cystitis in sexually active women. Human faeces are generally considered the primary reservoir for infection and the faecalperinealurethral pathway is the accepted route of infection. Two theories have been proposed for the pathogenesis of acute cystitis: (1) special pathogenicity, where uropathogenic (UPEC) encoding special virulence factors causes infection; and (2) prevalence, wherein ordinary faecal causes infection by simple mass action. The aim of this study was to compare concurrent urinary isolates from women with acute cystitis with their own dominant faecal, vaginal isolates; thus, these patients served as their own control. isolates from 80 women were analysed by phylotyping, virulence profiling (for 15 putative virulence genes) and enterobacterial repetitive intergenic consensus (ERIC) PCR. A virulence score was calculated for each isolate based on the number of virulence genes detected. Four host ecological groups of were created on the basis of ERIC PCR: group UVF, where vaginal and faecal isolates yielded the infecting urine clone; group UV, where only vaginal isolates yielded the infecting urine clone; group UF, where faecal isolates yielded the infecting urine clone; and group U, where the infecting urine clone was distinct. In the majority of cases the infecting clone from urine was also the dominant faecal clone (56.3 %; groups UVF and UF possessing high virulence scores of 4.6 and 3.9, respectively), indicating that both mechanisms play a role in pathogenesis. Non-dominant yet virulent faecal clones or an external source of seems a possibility in the UV group (13.7 %, VF score 4.8). In 30 % of patients (U group) the infecting urine clone was non-dominant and possessed a low virulence score (2.7); suggesting a possible role for host factors in establishing infection.

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2014-08-01
2019-12-14
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