High Virulence and Multidrug Resistance of Escherichia coli Isolated in Periodontal Disease.

Periodontal disease is caused by different gram-negative anaerobic bacteria; however, Escherichia coli has also been isolated from periodontitis and its role in periodontitis is less known. This study aimed to determine the variability in virulence genotype, antibiotic resistance phenotype, biofilm formation, phylogroups, and serotypes in different emerging periodontal strains of Escherichia coli, isolated from patients with periodontal disease and healthy controls. E. coli, virulence genes, and phylogroups, were identified by PCR, antibiotic susceptibility by the Kirby-Bauer method, biofilm formation was quantified using polystyrene microtiter plates, and serotypes were determined by serotyping. Although E. coli was not detected in the controls (n = 70), it was isolated in 14.7% (100/678) of the patients. Most of the strains (n = 81/100) were multidrug-resistance. The most frequent adhesion genes among the strains were fimH and iha, toxin genes were usp and hlyA, iron-acquisition genes were fyuA and irp2, and protectin genes were ompT, and KpsMT. Phylogroup B2 and serotype O25:H4 were the most predominant among the strains. These findings suggest that E. coli may be involved in periodontal disease due to its high virulence, multidrug-resistance, and a wide distribution of phylogroups and serotypes.

Virulence gene transcription, phylogroups, and antibiotic resistance of cervico-vaginal pathogenic E. coli in Mexico.

The pathogenicity of Escherichia coli strains that cause cervico-vaginal infections (CVI) is due to the presence of several virulence genes. The objective of this study was to define the variability regarding the genotype of antibiotic resistance, the transcription profiles of virulence genes after in vitro infection of the vaginal cell line A431 and the phylogroup composition of a group of cervico-vaginal E. coli strains (CVEC). A total of 200 E. coli strains isolated from Mexican women with CVI from two medical units of the Mexican Institute of Social Security were analysed. E. coli strains and antibiotic resistance genes were identified using conventional polymerase chain reaction (PCR), and phylogroups were identified using multiplex PCR. Virulence gene transcription was measured through reverse-transcriptase real-time PCR after infection of the vaginal cell line A431. The most common antibiotic resistance genes among the CVEC strains were aac(3)II, TEM, dfrA1, sul1, and qnrA. The predominant phylogroup was B2. The genes most frequently transcribed in these strains were fimH, papC, irp2, iroN, kpsMTII, cnf1, and ompT, mainly in CVEC strains isolated from chronic and occasional vaginal infections. The strains showed a large diversity of transcription of the virulence genes phenotype and antibiotic resistance genotype, especially in the strains of phylogroups, B2, A, and D. The strains formed 2 large clusters, which contained several subclusters. The genetic diversity of CVEC strains was high. These strains have a large number of transcription patterns of virulence genes, and one-third of them carry three to seven antibiotic resistance genes.

Comprehensive expression analysis of pathogenicity genes in uropathogenic Escherichia coli strains.

In this study, we investigated distinct expression patterns of genes encoding iron-acquisition systems, adhesins, protectins, and toxins in human uroepithelial cells infected with 194 uropathogenic Escherichia coli (UPEC) strains in vitro. We assessed the association of these genes with antibiotic resistance genes in this group of UPEC strains, previously characterised by polymerase chain reaction (PCR). Strains were isolated from patients with urinary tract infections (UTIs) from Unidad Médica Familiar de Salud Pública, located in Estado de México, México. Antibiotic resistance genes were identified by PCR, and the expression of virulence genes was detected by reverse-transcriptase-PCR after in vitro infection of cultured A431 human keratinocytes derived from a vulvar epidermoid carcinoma. The most frequently expressed virulence genotypes among the investigated UPEC strains included usp (68%), iha (64.9%), kpsMT (61.3%), fim (58.2%), irp2 (48.4), papC (33.5%), set (31.4%) and astA (30.9%), whereas the most frequently detected antibiotic resistance genes were tet(A) (34%), sul1 (31.4%) and TEM (26.3%). Furthermore, the most abundant pattern of gene expression (irp2/fim/iha/kpsMT/usp), associated with 8 different combinations of antibiotic resistance genotypes, was exhibited by 28 strains (14.4%). Taken together, these results indicate collective participation of distinct virulence UPEC genotypes during in vitro infection of cultured human epithelial cells, suggesting their potential involvement in UTI pathogenesis.

Histerectomía obstétrica: análisis de 15 años / Obstetric hysterectomy: analysis of 15 years

Determinar la incidencia, factores asociados y repercusiones de la histerectomía obstétrica. Estudio retrospectivo, descriptivo, analítico y transversal que incluyó 50 pacientes sometidas a histerectomía obstétrica en 64293 casos obstétricos, durante un período de 15 años (del 01 de agosto de 1993 al 31 de julio de 2008). Departamento de Obstetricia y Ginecología. Hospital Nuestra Señora de Chiquinquirá. Maracaibo, Venezuela. La incidencia de histerectomía obstétrica fue 0,07 por ciento (1 HO por 1 285 casos obstétricos). Fue más frecuente en mujeres entre 25-29 años (26 por ciento), IV gestas (34 por ciento), para 3 (26 por ciento), con control prenatal (63,33 por ciento), embarazos de 37-41semanas (56 por ciento), poscesárea (46 por ciento), histerectomía tipo total (86 por ciento), indicadas por atonía uterina (38 por ciento), complicadas con anemia (88 por ciento), ameritaron transfusión sanguínea (84 por ciento) y duraron <7 días de hospitalización (56 por ciento). Hubo 8 muertes maternas (16 por ciento) y la tasa de mortalidad materna ajustada fue 792 por 10000 nacidos vivos. Hubo 9 abortos (18 por ciento), 15 muertes fetales (30 por ciento) y la tasa de mortalidad perinatal fue 129 por 1000 nacidos vivos. En la población estudiada, la histerectomía obstétrica fue poco frecuente, más comúnmente indicada por trastornos hemorrágicos y tuvo cifras de morbilidad y mortalidad materna elevadas

To determine the incidence, associated factors and repercussions of obstetric hysterectomy. Retrospective, descriptive, analytic and transversal study that included 50 obstetric hysterectomies (OH) in 64293 obstetrics cases, during fifteen years (from August 1st, 1993 to July 31th, 2008). Department of Obstetrics and Gynecology. Our Lady of Chiquinquira Hospital. Maracaibo, Venezuela. The incidence of OH was 0.07 percent (1 OH by 1285 obstetric cases). It was more frequent in women between 25-29 years (26 percent), IV gestations (34 percent), para 3 (26 percent), prenatal care (63,33 percent), pregnancies 37-41 weeks (56 percent), after cesarean section (46 percent), total hysterectomy (86 percent), uterine atony as mean indication (38 percent), complicated with anemia (88 percent), blood transfusion (84 percent) and discharged home <7 days length of stay (56 percent). There were 8 maternal deaths (16 percent) and adjusted maternal mortality rate was 792 by 10000 live births. There were 9 abortions (18 percent), 15 fetal deaths (30 percent) and adjusted perinatal mortality rate was 129 by 1000 live births. Obstetric hysterectomy in the studied population, was not frequent, commonest indicated by hemorrhagic disorders and there were high maternal morbidity and mortality