Background: Urinary tract infection (UTI) is one of the common pediatric health problem.
The aim of the present study was to evaluate urinary tract infections in children in relations to virulence factors of Escherichia coli and to innate immune response with respect to IL6.
Methods: This investigation has been performed on a number of 2722 children their ages ranged from 1 to 12 years with a history of urinary tract infections (UTI) undergoing clinical manifestations presented to Pediatric University Hospital in Mansoura, Egypt. Urine samples were subjected to full microbiological assessment and measurement of interleukin 6 was performed for samples associated with Escherichia coli (E.coli). Furthermore, fimbriae genotypes papG were determined by multiplex PCR.
Results: Escherichia coli was the commonest isolate. For fimbria papG genotypes study, the commonest alleles were combined II and III followed by I and III. The interesting finding was the statistically significant association of allele II with multidrug resistant E.coli (51%). IL6 had significant positive correlations with both bacterial counts, total leucocytic counts in urine and. the presence of papG allele I and allele III (177pg/ml ±132, P=0.0001
Conclusions: There was high prevalence of UTI among patients in our study. The commonest pathogen was Escherichia coli. The results demonstrate that infections of the urinary tract activate IL-6 response in children and that the magnitude of the IL-6 response is influenced by the properties of the infecting strain. The severity of the infection represented by resistant to antibiotics and high urinary IL6 was associated with fimbria genotypes II and III. Urinary IL6 level can be used as a rapid biomarker for assessment of the severity of UTI in children.
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