Fimbriated E.coli urinary tract infection in Egyptian children

ABSTRACT

The issue of E. coli [UTI] in children has received considerable attension over the past two decades, in view of its potential of inducing renal scarring and subsequent functional problems in later life. In this study 56 children with [UTI] were subjected to detailed bacteriological studies, ultrasonographic assessment and whenever applicable, radiological and functional evaluation. E. coli was the commonest organism isolated from their urins, constituting 41.7% of single brands and 75% of mixed infections. 80.8% of E. coli infections involved the upper UT, thereby constituting 58.3% of the total organisms isolated from those patients. 88.5% of patients with E. coli pyelonephritis were P - blood group positive and in 67% the organism was P-fimbriated, as indicated by the Gal-Gal test. The prevalence of P-fimbriated organisms was lower in recurrent infections. Ultrasonographic assessment in patients with E. coli pyelonephritis showed normal findings in 50%, focal scarring in 34.6%, stones in 7.6% and bladder neck obstruction in 3.8%. Only 22.2% of patients with focal scarring had Gal-Gal positive E. coli infection. It is concluded that at P-fimbriated E. coli are virulent organisms that do not require organic UT lesions to cause pyelonephritis in P-blood group positive patients, known to have specific receptors for P-fimbriae