Associations of Escherichia coli papG adhesin classes with urinary tract infection

Uropathogenic E. coli express three known allelic variants of the pap encoded adhesin, but the epidemiological associations of these adhesin classes have not been completely defined. We used a multiply primed PCR method to test the prevalence of pap classes I (papG_J96), II (papG_IA2) and III (prsG_J96) among E. coli strains collected from young women and men with the clinical types of urinary tract infection (UTI) indicated below. We compared these isolates with fecal strains from young women and men without UTIs. Results: Isolate source N = Any pap Class I Class II Class III Female cystitis 103 47% 0 18% 27% pyelonephritis 49 71% 0 53% 10% fecal 52 33% 0 13% 17% Male cystitis 41 73% 0 41% 24% prostatitis 30 73% 0 50% 20% fecal 47 45% 0 32% 13% Conclusions: Among women, overall expression of pap was significantly more frequent in cystitis strains (P = .03) and pyelonephritis strains (P<.01) than among fecal isolates. Among UTI strains in women, pap Class II was significantly associated with pyelonephritis (P <.01) and pap class III was significantly associated with cystitis (P = .03). Among isolates from men, pap expression was significantly associated with cystitis or prostatitis (P <.03 vs fecal strains) and both pap classes II and III were seen in infecting strains.