Virulence factors of healthcare associated infection by uropathogenic E. coli strains isolated in Korea

Abstract

Background Escherichia coli (E.coli) is most predominant organism of urinary tract infection. There are only a few studies about the difference of virulent factors of healthcare associated urinary tract infection.

Methods The study was performed on 133 E. coliisolates from patients with urinary tract infection who were diagnosed at Keimyung university of Dongsan medical center from February 2015 through May 2016. Phylogenetic group and 29 virulence factors were identified by multiplex PCR. We compared antimicrobial susceptibility and virulence factors according to community acquired and healthcare associated infection.

Results The phylogenetic group analysis reveals that most of uropathogenic E.coli are group B2 and D. B2 was more frequently observed and D2 was lesser in healthcare associated infection: B2(95.5% vs. 72.1%), D(4.5% vs. 23.4%). Among the virulence factors, PAI, iutA were more related with healthcare associated infection. kpsMT II and K1 serotype was less observed in healthcare associated infection. Relapse within 3 months was more frequently observed in healthcare associated infection. Healthcare associated infection was more related with antimicrobial resistance and extended spectrum β-lactamase producing E.coli.

Conclusion In our study, community acquired and healthcare associated infection showed some differences of virulence factor in uropathogenic E. coli. Healthcare associated infection showed high presentation of iron metabolism-related virulence factor. Relapse was more frequently observed in healthcare associated infection.