VIRULENCE FACTORS AND PAP GENOTYPE IN ESCHERICHIA-COLI ISOLATES FROM WOMEN WITH ACUTE PYELONEPHRITIS, WITH OR WITHOUT BACTEREMIA

Bacteremia develops in a subgroup of patients with acute pyelonephriti s. This study examined isolates of Escherichia coli from the urine and the blood of 25 bacteremic and 67 nonbacteremic women with this acute disease. P-fimbriated strains were found in 100% of bacteremic patien ts without complicating factors but in only 71% of nonbacteremic patie nts without complications (P < .05). Non-P-fimbriated strains were onl y found to cause bacteremia in three patients with compromising host f actors. Strains from the bacteremic group and those from the nonbacter emic group did not differ significantly in terms of hemolysin or aerob actin production or of serum resistance. The P-fimbriated strains from both groups of patients carried pap DNA sequences of the papG(IA2) ad hesin type; prsG(J96) homologous DNA sequences were rare. The results suggested that P fimbriae and compromising host conditions independent ly increase the risk for bacteremia during acute pyelonephritis.