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. 2022 Jun 30;12(2):214-230.
doi: 10.18683/germs.2022.1324. eCollection 2022 Jun.

A comparative study of the clonal diversity and virulence characteristics of uropathogenic Escherichia coli isolated from Australian and Turkish (Turkey) children and adults with urinary tract infections

Dylan John Astley  1 , Labolina Spang  2 , Fatemeh Parnian  1 , Tara Vollmerhausen  3 , Huseyin Kilic  4 , Mehmet Hora  5 , Aycan Gundogdu  6 , Mohammad Katouli  7
Affiliations

A comparative study of the clonal diversity and virulence characteristics of uropathogenic Escherichia coli isolated from Australian and Turkish (Turkey) children and adults with urinary tract infections

Dylan John Astley et al. Germs. .

Abstract

Introduction: The virulence-associated gene (VAG) repertoire and clonal organization of uropathogenic Escherichia coli (UPEC) strains is influenced by host demographic, geographic locale, and the setting of urinary tract infection (UTI). Nevertheless, a direct comparison of these features among Australian and Turkish UPEC remains unexplored. Accordingly, this study investigated the clonal composition and virulence characteristics of a collection of UPEC isolated from Australian and Turkish UTI patients.

Methods: A total of 715 UPEC strains isolated from Australian (n=361) and Turkish (n=354) children and adults with hospital (HA)- and community-acquired (CA)-UTIs were included in this study. Typing of the strains using RAPD-PCR and PhPlate fingerprinting grouped all strains into 25 clonal groups (CGs). CG representatives were phylogrouped and screened for the presence of 18 VAGs associated with extraintestinal pathogenic E. coli.

Results: Turkish UPEC strains were characterized by high clonal diversity and predominance of the phylogroup D, while few distinct clonal groups with phylogenetic group B2 backgrounds dominated among the Australian strains. Twelve identical CGs were shared between ≥1 patient group from either country. Australian strains, particularly those isolated from children with HA-UTI, showed higher virulence potential than their Turkish counterparts, carrying significantly more genes associated with adhesion, iron acquisition and capsule biosynthesis.

Conclusions: This study identified identical CGs of UPEC causing HA- and CA-UTIs among Australian and Turkish UTI patients. These CGs frequently carried VAGs associated with adhesion, iron acquisition, immune evasion, and toxin production, which may contribute to their ability to disseminate internationally and to cause UTI.

Keywords: Australia; Turkey; Uropathogenic Escherichia coli; urinary tract infection.

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Conflict of interest statement

Conflicts of interest: All authors – none to declare.

Figures

Figure 1
Figure 1. Clonal composition and phylogenetic backgrounds of uropathogenic E. coli (UPEC) clonal groups (CGs) isolated from Australian (A) and Turkish (B) children and adults with hospital‐ (HA)‐ or community‐acquired (CA)‐UTI
The number of isolates represented by each CG are shown. TA‐H, Turkish adult with HA‐UTI (red circle); TA‐C, Turkish adult with CA‐UTI (dark blue circle); TC‐H, Turkish child with HA‐UTI (fuchsia circle); TC‐C, Turkish child with CA‐UTI (black circle); AA‐H, Australian adult with HA‐UTI (light blue circle); AA‐C, Australian adult with CA‐UTI (yellow circle); AC‐H, Australian child with HA‐UTI (green circle); AC‐C, Australian child with CA‐UTI (orange circle).
Figure 2
Figure 2. Distribution of clonal clusters (CCs) among a collection of E. coli isolated Australian and Turkish patients with urinary tract infection
CCs detected among ≥2 patient groups from either country are framed. The number of isolates represented by each CC are shown. Turkish adult with HA‐UTI (red circle); Turkish adult with CA‐UTI (dark blue circle); Turkish child with HA‐UTI (fuchsia circle); Turkish child with CA‐UTI (black circle); Australian adult with HA‐UTI (light blue circle); Australian adult with CA‐UTI (yellow circle); Australian child with HA‐UTI (green circle); Australian child with CA‐UTI (orange circle).
Figure 3
Figure 3. Virulence‐associated gene (VAG) scores (mean ± SEM) among clonal groups (CGs) of uropathogenic E. coli (UPEC) isolated from Turkish (white box) and Australian (black box) children and adults with community‐acquired (CA‐, A) or hospital‐acquired (HA‐ B) urinary tract infections (UTIs) *p≤0.050
AC – adult with CA‐UTI; AH – adult with HA‐UTI; CC – child with CA‐UTI; CH – child with HA‐UTI.
Figure 4
Figure 4. Prevalence (%) of virulence‐associated genes (VAGs) among clonal groups (CGs) of uropathogenic E. coli (UPEC) isolated from Turkish (white box) and Australian (black box) children and adults with hospital‐ (HA) or community‐acquired (CA)‐ urinary tract infections (UTIs). VAGs were assigned to one of five classifications based on their putative functions such as bacterial adhesion (A), iron acquisition (B), toxin production (C), capsule biosynthesis (D) or other functions (E)
AC – adult with CA‐UTI; AH – adult with HA‐UTI; CC – child with CA‐UTI; CH – child with HA‐UTI.
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