Journal article
Relationship Among Bacterial Virulence, Bladder Dysfunction, Vesicoureteral Reflux and Patterns of Urinary Tract Infection in Children
The Journal of urology, Vol.188(1), pp.236-241
07/2012
DOI: 10.1016/j.juro.2012.03.025
PMID: 22595065
Abstract
We hypothesized that virulence levels of Escherichia coli isolates causing pediatric urinary tract infections differ according to severity of infection and also among various uropathies known to contribute to pediatric urinary tract infections. We evaluated these relationships using in vitro cytokine interleukin-6 elicitation.
E. coli isolates were cultured from children presenting with urinary tract infections. In vitro cytokine (interleukin-6) elicitation was quantified for each isolate and the bacteria were grouped according to type of infection and underlying uropathy (neurogenic bladder, nonneurogenic bowel and bladder dysfunction, primary vesicoureteral reflux, no underlying etiology).
A total of 40 E. coli isolates were collected from children with a mean age of 61.5 months (range 1 to 204). Mean level of in vitro cytokine elicitation from febrile urinary tract infection producing E. coli was significantly lower than for nonfebrile strains (p = 0.01). The interleukin-6 response to E. coli in the neurogenic bladder group was also significantly higher than in the vesicoureteral reflux (p = 0.01) and no underlying etiology groups (p = 0.02).
In vitro interleukin-6 elicitation, an established marker to determine bacterial virulence, correlates inversely with clinical urinary tract infection severity. Less virulent, high cytokine producing E. coli were more likely to cause cystitis and were more commonly found in patients with neurogenic bladder and nonneurogenic bowel and bladder dysfunction, whereas higher virulence isolates were more likely to produce febrile urinary tract infections and to affect children with primary vesicoureteral reflux and no underlying etiology. These findings suggest that bacteria of different virulence levels may be responsible for differences in severity of pediatric urinary tract infections and may vary among different underlying uropathies.
Details
- Title: Subtitle
- Relationship Among Bacterial Virulence, Bladder Dysfunction, Vesicoureteral Reflux and Patterns of Urinary Tract Infection in Children
- Creators
- Douglas W. Storm - Naval Medical Center San DiegoAshay S. Patel - Arkansas Children's HospitalDennis J. Horvath - Nationwide Children's HospitalBirong Li - Nationwide Children's HospitalStephen A. Koff - The Ohio State UniversitySheryl S. Justice - Nationwide Children's Hospital
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.188(1), pp.236-241
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.juro.2012.03.025
- PMID
- 22595065
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Grant note
- Research Institute at Nationwide Children's Hospital
- Language
- English
- Date published
- 07/2012
- Academic Unit
- Stead Family Department of Pediatrics; Urology
- Record Identifier
- 9984319993102771
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