Mannose resistant adherence and serotyping of Escherichia coli causing recurrent urinary tract infection in pediatric age group

ABSTRACT

Urinary tract infection in the pediatric age group is a disease of major concern. Clinical diagnosis, if unaided, cannot be relied upon as the symptoms and signs are nospecific resulting in false diagnosis. Appropriate managemwent will depend primarily on microbiologic examination. The present study comparised 84 patients [33 Males and 15 Females] complaining of frequently recurrent urinary tract symptoms who underwent full microbiological investigations starting by repeated viable bacterial counts, including systematic bacterial identification of the isolates to the species level and finally focusing on the virulence characterization of the commonest causative species i.e. Escherichia coli [E.coli] by the mannose resistant aldherence power and serotypig. Using viable bacterial count only 46 cases [56%] showed positive significant bacterial growth. The commonest causative pathogen was, as predicated, E.coli [60.9%] followed by Klebsiella [19.6%]. Staphylococcus [15.2%] and Proteus spp., [4.3%]. Of the E.coli strains, 71.4% turned to be mannose-resistant adherent mainly with the diffuse pattern to hpp[-2] cells, a finding usually associated with uroadherence and attributed to P fimbriae. Serotypoing of E.coli did not conform to published literature as it did not correlate with uropathogenesis. These results highlight the role of adherence for an in invading orgarism but rather as an additional virulence factor in cases of frequently recurrent urinary tract infection. Further studies to illustrate the relative importance of such factors and/or markers in the patogensis and the immune mechanisms are therefore needed