Abstract：
BACKGROUND: Urinary tract infection (UTI) recurrence is important in immunocompromised patients. There is a trend to study genotypically and phenotypically the role of certain virulence factors of Escherichia coli in the diagnosis of recurrent UTI. The main objective of this study was to determine if there is an association between phenotypic characteristics of E coli and UTI recurrence in immunocompromised patients.
METHODS: A case-control study was performed on immunocompromised patients from Hospital Regional de Alta Especialidad del Bajío, Mexico. E coli strains isolated from these patients were identificated and antimicrobial susceptibility test were performed. Strains with filamented cell morphology, mucoid colonial phenotype, or biofilm production were considered cases. Strains without the characteristics were considered controls. UTI recurrence was identified based on clinical records. The odds ratio (OR) was calculated to quantify the magnitude of the association.
RESULTS: An association between filamented cell morphology and UTI recurrence was found (OR = 2.19 95% CI 1.06-4.51; P = .031). No association was found between mucoid colony morphology (P>.05) or biofilm production (P>.05) and UTI recurrence. An association between mucoid colony morphology and extended-spectrum β-lactamase production was found (OR = 3.09 95% 1.59-5.99; P<.001).
CONCLUSIONS: Filamented cell morphology and mucoid colonial phenotype may have a possible diagnostic value for the detection of UTI recurrence and antimicrobial resistance. Further diagnostic test studies are needed to fully assess their clinical utility.
METHODS: A case-control study was performed on immunocompromised patients from Hospital Regional de Alta Especialidad del Bajío, Mexico. E coli strains isolated from these patients were identificated and antimicrobial susceptibility test were performed. Strains with filamented cell morphology, mucoid colonial phenotype, or biofilm production were considered cases. Strains without the characteristics were considered controls. UTI recurrence was identified based on clinical records. The odds ratio (OR) was calculated to quantify the magnitude of the association.
RESULTS: An association between filamented cell morphology and UTI recurrence was found (OR = 2.19 95% CI 1.06-4.51; P = .031). No association was found between mucoid colony morphology (P>.05) or biofilm production (P>.05) and UTI recurrence. An association between mucoid colony morphology and extended-spectrum β-lactamase production was found (OR = 3.09 95% 1.59-5.99; P<.001).
CONCLUSIONS: Filamented cell morphology and mucoid colonial phenotype may have a possible diagnostic value for the detection of UTI recurrence and antimicrobial resistance. Further diagnostic test studies are needed to fully assess their clinical utility.
摘要：
背景：UTI复发在免疫受损患者中很重要。有一种趋势是在基因型和表型上研究大肠杆菌某些毒力因子在复发性UTI诊断中的作用。这项研究的主要目的是确定在免疫受损患者中大肠杆菌的表型特征与UTI复发之间是否存在关联。
方法：对来自AltaEspecialidaddelBajío医院区域的免疫功能低下患者进行了病例对照研究，墨西哥。鉴定了从这些患者中分离的大肠杆菌菌株并进行了抗菌药敏试验。具有丝状细胞形态的菌株，粘液菌落表型或生物膜产生被认为是病例。没有这些特征的菌株被认为是对照。根据临床记录确定UTI复发。计算赔率比以量化关联的大小。
结果：发现丝状细胞形态与UTI复发之间存在关联（OR=2,1995％CI1,06-4,51；p=0,031）。在粘液集落形态(p>0.05)或生物膜产生(p>0.05)与UTI复发之间未发现关联。发现粘液菌落形态与ESBL产生之间的关联(OR=3,0995%1,59-5,99;p<0,001)。
结论：丝状细胞形态和粘液样集落表型可能对检测UTI复发和抗菌药物耐药性具有可能的诊断价值。需要进一步的诊断测试研究来全面评估其临床效用。
方法：对来自AltaEspecialidaddelBajío医院区域的免疫功能低下患者进行了病例对照研究，墨西哥。鉴定了从这些患者中分离的大肠杆菌菌株并进行了抗菌药敏试验。具有丝状细胞形态的菌株，粘液菌落表型或生物膜产生被认为是病例。没有这些特征的菌株被认为是对照。根据临床记录确定UTI复发。计算赔率比以量化关联的大小。
结果：发现丝状细胞形态与UTI复发之间存在关联（OR=2,1995％CI1,06-4,51；p=0,031）。在粘液集落形态(p>0.05)或生物膜产生(p>0.05)与UTI复发之间未发现关联。发现粘液菌落形态与ESBL产生之间的关联(OR=3,0995%1,59-5,99;p<0,001)。
结论：丝状细胞形态和粘液样集落表型可能对检测UTI复发和抗菌药物耐药性具有可能的诊断价值。需要进一步的诊断测试研究来全面评估其临床效用。
