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The present work set out to search for a virulence repertoire distinctive for  Escherichia coli  causing primitive acute pyelonephritis (APN). To this end, the virulence potential of 18  E .  coli  APN strains was genotypically and phenotypically assessed, comparatively with 19 strains causing recurrent cystitis (RC), and 16 clinically not significant (control, CO) strains. Most of the strains belong to phylogenetic group B1 (69.8%;  p <0.01), and APN strains showed unique features, which are the presence of phylogroup A, and the absence of phylogroup B2 and non-typeable strains. Overall, the most dominant virulence factor genes (VFGs) were  ecpA  and  fyuA  (92.4 and 86.7%, respectively;  p <0.05), and the mean number of VFGs was significantly higher in uropathogenic strains. Particularly,  papAH  and  malX  were exclusive for uropathogenic strains. APN and RC strains showed a significantly higher prevalence of  fyuA ,  usp , and  malX  than of CO strains. Compared to RC strains, APN ones showed a higher prevalence of  iha , but a lower prevalence of  iroN ,  cnf1 , and  kpsMT-II . Hierarchical cluster analysis showed a higher proportion of two gene clusters ( malX  and  usp , and  fyuA  and  ecpA ) were detected in the APN and RC groups than in CO, whereas  iutA  and  iha  clusters were detected more frequently in APN strains. The motility level did not differ among the study-groups and phylogroups considered, although a higher proportion of swarming strains was observed in APN strains. Antibiotic-resistance rates were generally low except for ampicillin (37.7%), and were not associated with specific study- or phylogenetic groups. APN and RC strains produced more biofilm than CO strains. In APN strains,  iha  was associated with higher biofilm biomass formation, whereas  iroN  and  KpSMT-K1  were associated with a lower amount of biofilm biomass. Further work is needed to grasp the virulence and fitness mechanisms adopted by  E .  coli  causing APN, and hence develop new therapeutic and prophylactic approaches.

plos one

Phylogenetic relationships, biofilm formation, motility, antibiotic resistance and extended virulence genotypes among Escherichia coli strains from women with community-onset primitive acute pyelonephritis