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Open AccessArticle

Phenotypic and Genotypic Characterization of Escherichia coli Causing Urinary Tract Infections in Kidney-Transplanted Patients

1
Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital Münster, 48149 Münster, Germany
2
Institute of Hygiene, University of Münster, 48149 Münster, Germany
3
Institute of Biostatistics and Clinical Research, University of Münster, 48149 Münster, Germany
4
Institute for Human Genetics, University of Münster, 48149 Münster, Germany
5
Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2019, 8(7), 988; https://doi.org/10.3390/jcm8070988
Received: 3 June 2019 / Revised: 1 July 2019 / Accepted: 5 July 2019 / Published: 7 July 2019
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Kidney Transplantation)
Urinary tract infection (UTI), frequently caused by uropathogenic Escherichia coli (UPEC), is the most common infection after kidney transplantation (KTx). Untreated, it can lead to urosepsis and impairment of the graft function. We questioned whether the UPEC isolated from KTx patients differed from the UPEC of non-KTx patients. Therefore, we determined the genome sequences of 182 UPEC isolates from KTx and control patients in a large German university clinic and pheno- and genotypically compared these two isolated groups. Resistance to the β-lactams, trimethoprim or trimethoprim/sulfamethoxazole was significantly higher among UPEC from KTx than from control patients, whereas both the isolated groups were highly susceptible to fosfomycin. Accordingly, the gene content conferring resistance to β-lactams or trimethoprim, but also to aminoglycosides, was significantly higher in KTx than in control UPEC isolates. E. coli isolates from KTx patients more frequently presented with uncommon UPEC phylogroups expressing higher numbers of plasmid replicons, but interestingly, less UPEC virulence-associated genes than the control group. We conclude that there is no defining subset of virulence traits for UPEC from KTx patients. The clinical history and immunocompromised status of KTx patients enables E. coli strains with low uropathogenic potential, but with increased antibiotic resistance to cause UTIs. View Full-Text
Keywords: Uropathogenic E. coli; UPEC; phylogeny; genomics; antibiotic resistance; virulence traits; kidney transplantation Uropathogenic E. coli; UPEC; phylogeny; genomics; antibiotic resistance; virulence traits; kidney transplantation
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Abo Basha, J.; Kiel, M.; Görlich, D.; Schütte-Nütgen, K.; Witten, A.; Pavenstädt, H.; Kahl, B.C.; Dobrindt, U.; Reuter, S. Phenotypic and Genotypic Characterization of Escherichia coli Causing Urinary Tract Infections in Kidney-Transplanted Patients. J. Clin. Med. 2019, 8, 988.

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