Bioprofiles of gram-negative bacteria with recurrent lower urinary tract infection

Uncomplicated recurrent lower urinary tract infection is a pressing problem not only for urologists, but also for clinical microbiologists. Currently, there are no quantitative indicators of diagnostically significant bacteriuria levels, which complicates the interpretation of bacteriological test results. The chronic and recurrent nature of the disease may be associated not only with quantitative, but also with qualitative (pathogenic, persistent) characteristics of uropathogens.

Objective: to study the relationship between hemolytic, antilysozyme activities, extended-spectrum βlactamase production with virulence genes in gram-negative uropathogens in uncomplicated recurrent lower urinary tract infection in women. Proven pathogens, representatives of gram-negative microbiota with a predominance of E. coli (74.2 %), were isolated from the urine of 62 patients with uncomplicated recurrent lower urinary tract infection. In all strains isolated from urine the virulence genes were determined: papA, papE/F, papGII, afa, bmaE, fyuA, iutA, feoB, kpsMII, usp. These virulence genes were responsible for adhesion, iron absorption system, capsule synthesis and uropathogenic specific protein. In parallel, hemolytic activity, antilysozyme activity, as well as production of extendedspectrum β-lactamases were determined in the isolated strains. The study showed that strains of gram-negative bacteria isolated from the urine of patients in most cases had hemolytic activity (61.3 %), production of extended-spectrum βlactamases (56.5 %). All strains had antilysozyme activity and in all of them the studied virulence genes were presented. The presence of hemolytic activity was reliably associated with such virulence genes as feoB, fyuA, usp, papA, kpsMII; the presence of antilysozyme activity was associated with papA, afa and fyuA; production of extended-spectrum βlactamases – with papA and fyuA. Common virulence genes for which a relationship with the presence of hemolytic activity, antilysozyme activity, production of extended-spectrum β-lactamases were papA and fyuA. The detected reliable correlation relationships between the studied features with certain virulence genes more likely can lead to a chronic and recurrent course of the disease and maintenance of the infectious and inflammatory process in the urinary tract.

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