Skip to main content
NCBI home page
Infectious Diseases in Obstetrics and Gynecology logoLink to Infectious Diseases in Obstetrics and Gynecology
. 2001;9(4):203–207. doi: 10.1155/S1064744901000333

Virulence Factors of Escherichia coli Isolated From Female Reproductive Tract Infections and Neonatal Sepsis

Susan W Cook 1, Hunter A Hammill 2,3, Richard A Hull 3,4,✉
PMCID: PMC1784658  PMID: 11916176

Abstract

Objective: The presence of enterobacteria such as Escherichia coli in the vagina of normal women is not synonymous with infection. However, vaginal E. coli may also cause symptomatic infections. We examined bacterial virulenceproperties that may promote symptomatic female reproductive tract infections (RTI) and neonatal sepsis.

Methods: E. coli isolated as the causative agent from cases of vaginitis (n = 50), tubo-ovarian abscess (n = 45) and neonatal sepsis (n = 45) was examined for selected phenotypic and genetic virulence properties. Results were compared with the frequency of the same properties among fecal E. coli not associated with disease.

Results: A significantly greater proportion of infection E. coli exhibited D-mannose resistant hemagglutination compared with fecal E. coli (p < 0.01). This adherence phenotype was associated with the presence of P fimbriae (pap) genes which were also significantly more prevalent among isolates from all three infection sites (p < 0.01). The majority of pap+ isolates contained the papG3 allele (Class II) regardless of infection type. Increased frequency of Type 1C genes among vaginitis and abscess isolates was also noted. No significant differences in frequency of other bacterial adherence genes, fim, sfa, uca (gaf) or dra were observed. E. coli associated with vaginitis was significantly more likely to be hemolytic ( HIy+) than were fecal isolates (p < 0.05). The HIy+ phenotype was also more prevalent among tubo-ovarian abscess and neonatal sepsis isolates (p < 0.08).

Conclusions: E. coli isolated from female RTI and neonatal sepses possess unique properties that may enhance their virulence. These properties are similar to those associated with other E. coli extra-intestinal infections, indicating that strategies such as vaccination or bacterial interference that may be developed against urinary tract infections (UTI) and other E. coli extra-intestinal infections may also prevent selected female RTI.

Full Text

The Full Text of this article is available as a PDF (118.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Buchanan K., Falkow S., Hull R. A., Hull S. I. Frequency among Enterobacteriaceae of the DNA sequences encoding type 1 pili. J Bacteriol. 1985 May;162(2):799–803. doi: 10.1128/jb.162.2.799-803.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Crombleholme W. R., Ohm-Smith M., Robbie M. O., DeKay V., Sweet R. L. Ampicillin/sulbactam versus metronidazole-gentamicin in the treatment of soft tissue pelvic infections. Am J Obstet Gynecol. 1987 Feb;156(2):507–512. doi: 10.1016/0002-9378(87)90321-8. [DOI] [PubMed] [Google Scholar]
  3. Hammill H. A. Normal vaginal flora in relation to vaginitis. Obstet Gynecol Clin North Am. 1989 Jun;16(2):329–336. [PubMed] [Google Scholar]
  4. Hedlund M., Svensson M., Nilsson A., Duan R. D., Svanborg C. Role of the ceramide-signaling pathway in cytokine responses to P-fimbriated Escherichia coli. J Exp Med. 1996 Mar 1;183(3):1037–1044. doi: 10.1084/jem.183.3.1037. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hull R. A., Hull S. I., Falkow S. Frequency of gene sequences necessary for pyelonephritis-associated pili expression among isolates of Enterobacteriaceae from human extraintestinal infections. Infect Immun. 1984 Mar;43(3):1064–1067. doi: 10.1128/iai.43.3.1064-1067.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hull R. A., Rudy D. C., Donovan W. H., Wieser I. E., Stewart C., Darouiche R. O. Virulence properties of Escherichia coli 83972, a prototype strain associated with asymptomatic bacteriuria. Infect Immun. 1999 Jan;67(1):429–432. doi: 10.1128/iai.67.1.429-432.1999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hull R., Rudy D., Donovan W., Svanborg C., Wieser I., Stewart C., Darouiche R. Urinary tract infection prophylaxis using Escherichia coli 83972 in spinal cord injured patients. J Urol. 2000 Mar;163(3):872–877. [PubMed] [Google Scholar]
  8. Hultgren S. J., Porter T. N., Schaeffer A. J., Duncan J. L. Role of type 1 pili and effects of phase variation on lower urinary tract infections produced by Escherichia coli. Infect Immun. 1985 Nov;50(2):370–377. doi: 10.1128/iai.50.2.370-377.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Johnson J. R., Russo T. A., Brown J. J., Stapleton A. papG alleles of Escherichia coli strains causing first-episode or recurrent acute cystitis in adult women. J Infect Dis. 1998 Jan;177(1):97–101. doi: 10.1086/513824. [DOI] [PubMed] [Google Scholar]
  10. Johnson J. R. Virulence factors in Escherichia coli urinary tract infection. Clin Microbiol Rev. 1991 Jan;4(1):80–128. doi: 10.1128/cmr.4.1.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Johnson J. R. papG alleles among Escherichia coli strains causing urosepsis: associations with other bacterial characteristics and host compromise. Infect Immun. 1998 Sep;66(9):4568–4571. doi: 10.1128/iai.66.9.4568-4571.1998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Karr J. F., Nowicki B. J., Truong L. D., Hull R. A., Moulds J. J., Hull S. I. pap-2-encoded fimbriae adhere to the P blood group-related glycosphingolipid stage-specific embryonic antigen 4 in the human kidney. Infect Immun. 1990 Dec;58(12):4055–4062. doi: 10.1128/iai.58.12.4055-4062.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Klann A. G., Hull R. A., Hull S. I. Sequences of the genes encoding the minor tip components of Pap-3 pili of Escherichia coli. Gene. 1992 Sep 21;119(1):95–100. doi: 10.1016/0378-1119(92)90071-v. [DOI] [PubMed] [Google Scholar]
  14. Krohn M. A., Thwin S. S., Rabe L. K., Brown Z., Hillier S. L. Vaginal colonization by Escherichia coli as a risk factor for very low birth weight delivery and other perinatal complications. J Infect Dis. 1997 Mar;175(3):606–610. doi: 10.1093/infdis/175.3.606. [DOI] [PubMed] [Google Scholar]
  15. Langermann S., Palaszynski S., Barnhart M., Auguste G., Pinkner J. S., Burlein J., Barren P., Koenig S., Leath S., Jones C. H. Prevention of mucosal Escherichia coli infection by FimH-adhesin-based systemic vaccination. Science. 1997 Apr 25;276(5312):607–611. doi: 10.1126/science.276.5312.607. [DOI] [PubMed] [Google Scholar]
  16. Mitsumori K., Terai A., Yamamoto S., Yoshida O. Identification of S, F1C and three PapG fimbrial adhesins in uropathogenic Escherichia coli by polymerase chain reaction. FEMS Immunol Med Microbiol. 1998 Aug;21(4):261–268. doi: 10.1111/j.1574-695X.1998.tb01173.x. [DOI] [PubMed] [Google Scholar]
  17. Nowicki B., Svanborg-Edén C., Hull R., Hull S. Molecular analysis and epidemiology of the Dr hemagglutinin of uropathogenic Escherichia coli. Infect Immun. 1989 Feb;57(2):446–451. doi: 10.1128/iai.57.2.446-451.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Percival-Smith R., Bartlett K. H., Chow A. W. Vaginal colonization of Escherichia coli and its relation to contraceptive methods. Contraception. 1983 May;27(5):497–504. doi: 10.1016/0010-7824(83)90046-x. [DOI] [PubMed] [Google Scholar]
  19. Stapleton A., Hooton T. M., Fennell C., Roberts P. L., Stamm W. E. Effect of secretor status on vaginal and rectal colonization with fimbriated Escherichia coli in women with and without recurrent urinary tract infection. J Infect Dis. 1995 Mar;171(3):717–720. doi: 10.1093/infdis/171.3.717. [DOI] [PubMed] [Google Scholar]

Articles from Infectious Diseases in Obstetrics and Gynecology are provided here courtesy of Wiley

RESOURCES