Bacterial characteristics and glycemic control in diabetic patients with Escherichia coli urinary tract infection

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Abstract

Background: Patients with diabetes mellitus have an increased risk of infection. The roles of bacterial characteristics and glycemic control in diabetic patients with Escherichia coli infection have not been well investigated. The aims of this study were to examine the bacterial characteristics and glycemic control in diabetic patients with E. coli infections arising in the urinary tract. Methods: A total of 271 E. coli isolates were collected from urine and bloodstream. Phylogenetic groups, the presence of virulence genes, and antimicrobial susceptibility of E. coli isolates were determined. Results: There were few differences in E. coli bacterial characteristics between 190 diabetic and 81 nondiabetic patients. In diabetic patients with urosepsis, there was a higher hemoglobin A1C level, and the related E. coli strains had more neuA, papG II, afa and hlyA genes, and a lower prevalence of antimicrobial resistance to cephalosporins and fluoroquinolones than those with asymptomatic bacteriuria and urinary tract infection. Multivariate logistic regression analysis revealed that increased hemoglobin A1C and presence of papG II and afa genes were independent factors associated with development of urosepsis in diabetic patients. Conclusion: This study demonstrated that more virulent E. coli isolates, especially with papG II and afa genes, and poorer glycemic control were important determinants for development of urosepsis in diabetic patients.

Original languageEnglish
Pages (from-to)24-29
Number of pages6
JournalJournal of Microbiology, Immunology and Infection
Volume46
Issue number1
DOIs
Publication statusPublished - 2013 Feb 1

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Urinary Tract Infections
Escherichia coli
Escherichia coli Infections
Genes
Hemoglobins
Cephalosporin Resistance
Bacteriuria
Fluoroquinolones
Urinary Tract
Virulence
Diabetes Mellitus
Logistic Models
Regression Analysis
Urine
Infection

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "Bacterial characteristics and glycemic control in diabetic patients with Escherichia coli urinary tract infection",
abstract = "Background: Patients with diabetes mellitus have an increased risk of infection. The roles of bacterial characteristics and glycemic control in diabetic patients with Escherichia coli infection have not been well investigated. The aims of this study were to examine the bacterial characteristics and glycemic control in diabetic patients with E. coli infections arising in the urinary tract. Methods: A total of 271 E. coli isolates were collected from urine and bloodstream. Phylogenetic groups, the presence of virulence genes, and antimicrobial susceptibility of E. coli isolates were determined. Results: There were few differences in E. coli bacterial characteristics between 190 diabetic and 81 nondiabetic patients. In diabetic patients with urosepsis, there was a higher hemoglobin A1C level, and the related E. coli strains had more neuA, papG II, afa and hlyA genes, and a lower prevalence of antimicrobial resistance to cephalosporins and fluoroquinolones than those with asymptomatic bacteriuria and urinary tract infection. Multivariate logistic regression analysis revealed that increased hemoglobin A1C and presence of papG II and afa genes were independent factors associated with development of urosepsis in diabetic patients. Conclusion: This study demonstrated that more virulent E. coli isolates, especially with papG II and afa genes, and poorer glycemic control were important determinants for development of urosepsis in diabetic patients.",
author = "Ming-Cheng Wang and Chin-Chung Tseng and An-Bang Wu and Wei-Hung Lin and Ching-Hao Teng and Yan, {Jing Jou} and Wu, {Jiunn Jong}",
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T1 - Bacterial characteristics and glycemic control in diabetic patients with Escherichia coli urinary tract infection

AU - Wang, Ming-Cheng

AU - Tseng, Chin-Chung

AU - Wu, An-Bang

AU - Lin, Wei-Hung

AU - Teng, Ching-Hao

AU - Yan, Jing Jou

AU - Wu, Jiunn Jong

PY - 2013/2/1

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N2 - Background: Patients with diabetes mellitus have an increased risk of infection. The roles of bacterial characteristics and glycemic control in diabetic patients with Escherichia coli infection have not been well investigated. The aims of this study were to examine the bacterial characteristics and glycemic control in diabetic patients with E. coli infections arising in the urinary tract. Methods: A total of 271 E. coli isolates were collected from urine and bloodstream. Phylogenetic groups, the presence of virulence genes, and antimicrobial susceptibility of E. coli isolates were determined. Results: There were few differences in E. coli bacterial characteristics between 190 diabetic and 81 nondiabetic patients. In diabetic patients with urosepsis, there was a higher hemoglobin A1C level, and the related E. coli strains had more neuA, papG II, afa and hlyA genes, and a lower prevalence of antimicrobial resistance to cephalosporins and fluoroquinolones than those with asymptomatic bacteriuria and urinary tract infection. Multivariate logistic regression analysis revealed that increased hemoglobin A1C and presence of papG II and afa genes were independent factors associated with development of urosepsis in diabetic patients. Conclusion: This study demonstrated that more virulent E. coli isolates, especially with papG II and afa genes, and poorer glycemic control were important determinants for development of urosepsis in diabetic patients.

AB - Background: Patients with diabetes mellitus have an increased risk of infection. The roles of bacterial characteristics and glycemic control in diabetic patients with Escherichia coli infection have not been well investigated. The aims of this study were to examine the bacterial characteristics and glycemic control in diabetic patients with E. coli infections arising in the urinary tract. Methods: A total of 271 E. coli isolates were collected from urine and bloodstream. Phylogenetic groups, the presence of virulence genes, and antimicrobial susceptibility of E. coli isolates were determined. Results: There were few differences in E. coli bacterial characteristics between 190 diabetic and 81 nondiabetic patients. In diabetic patients with urosepsis, there was a higher hemoglobin A1C level, and the related E. coli strains had more neuA, papG II, afa and hlyA genes, and a lower prevalence of antimicrobial resistance to cephalosporins and fluoroquinolones than those with asymptomatic bacteriuria and urinary tract infection. Multivariate logistic regression analysis revealed that increased hemoglobin A1C and presence of papG II and afa genes were independent factors associated with development of urosepsis in diabetic patients. Conclusion: This study demonstrated that more virulent E. coli isolates, especially with papG II and afa genes, and poorer glycemic control were important determinants for development of urosepsis in diabetic patients.

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