SHICHIRI Yasumasa Kyoto University, Urology, Instructor, 医学研究科, 助手 (20263080)
TERAI Akito Kyoto University, Urology, Instructor, 医学研究科, 助手 (50243019)
YOSHIMURA Naoki Kyoto University, Urology, Instructor, 医学研究科, 助手 (70230810)
KAKEHI Yoshiyuki Kyoto University, Urology, Assistant professor, 医学研究科, 講師 (20214273)
YOSHIDA Osamu Kyoto University, Urology, professor, 医学研究科, 教授 (70025584)
|Budget Amount *help
¥2,400,000 (Direct Cost : ¥2,400,000)
Fiscal Year 1997 : ¥600,000 (Direct Cost : ¥600,000)
Fiscal Year 1996 : ¥1,800,000 (Direct Cost : ¥1,800,000)
Escherichia coli is the most frequent pathogen in acute bacterial prostatitis as well as in acute uncomplicated urinary infections. To assess the virulence profiles of E.coil in acute prostatitis, the serotypes and virulence factor (VF) genotypes were determined. We studied 107 E.coli isolates from acute bacterial prostatitis, 76 isolates from acute pyelonephritis, 194 isolates from acute cystitis and 80 fecal isolates from healthy people. Ten urovirulence determinants were analyzed by DNA colony hybridization or PCR, including the genes for type 1 fimbria (pil), P fimbrial adhesin (papGl_<J96>. PapGIA_<IA2>), F fimbrial adhesin (prsG_<J96>), S fimbria (sfa), PlC fimbria (foc), afimbrial adhesin AFA-I (afal), a-hemolysin (hly), cytotoxic necrotizing factor 1 (cnfl) and aerobactin (aer). Furthermore, in vitro expression of Vfs and adhesion assay of fimbrial adhesins to the human prostatic tissue were performed. 0 : H : K serotypes were also determined.
With the exception of pil and afal,
all VFs were significantly associated with the prostatitis than with the fecal isolates. Although in vivo expression could not be evaluated, more than half of genotype positive strains were confirmed their in vitro expression. The prevalence of hly and cnfl was higher in the prostatitis isolates than in the pyelonephritis and cystitis isolates. Effect of fimbrial adhesin on the probability of a strain to cause prostatitis was assessed by the regression analysis. The results of multivariate analysi. revealed that AFA-I and FIC fimbria had high relative virulence. The adhesion assay showed that All mannose-resistant fimbrial adhesins except PapG_<J96> mediated bacterial adherence to human prostatic tissue. Nine 0 serotypes (01, 02, 04, 06, 016, 018, 022, 025 and 075) accounted for 79.4%, 73.7% and 78.4% of the prostatitis, pyelonephritis and cystitis strains, respectively. There was an apparent correlation between the serotypes and genotypes in uropathogenic E.coli. Predominance of 0 serotypes prevalent in female urinary tract infections and a high percentage of multiple VFs among the prostatitis isolates suggested that VFs have important roles in the pathogenesis of acute bacterial prostatitis.
Next, to verify the rout of the infection, we compared the clonality of Escherichia coli isolates from the urine and rectal swab of 8 adult men with acute bacterial proslatis. In a case, the fecsl isolates of patient's wife were also examined. The clonality of the urinary and fecal isolates were evaluated by genotyping of 6 urovirulence determinants and pulsed-field gel electrophoresis.
The E.coli strains causing prostatitis were not present in the rectal swab in all cases except one patient of whom wife harboring the same E.coli isolate in the fecus as causing pathogen of her husband. Our results indicate that the pathogen of prostatitis may come from their sexcial pertoner in a part of the patients. Less