• Medientyp: E-Artikel
  • Titel: Virulence Factors of Escherichia coli Contribute to Acute Renal Failure
  • Beteiligte: Kreft, Burkhard; Pagel, Horst
  • Erschienen: S. Karger AG, 2000
  • Erschienen in: Nephron Experimental Nephrology, 8 (2000) 4-5, Seite 244-251
  • Sprache: Englisch
  • DOI: 10.1159/000020675
  • ISSN: 1660-2129
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  • Beschreibung: <i>Background:</i> The development of acute renal failure (ARF) significantly enhances the mortality of patients with Gram-negative septic shock. The role of specific bacterial virulence factors different from lipopolysaccharides (LPS) in the deterioration of renal function in septic shock remains to be determined. <i>Methods:</i> An <i>Escherichia coli</i> wild-type strain (536/21 WT, O6:K15:H31) was isolated from a patient suffering from a urinary tract infection. The strain expresses various virulence factors (e.g. hemolysin, fimbriae) genetically encoded by pathogenicity islands. The spontaneous deletion mutant 536/21 Del lacks the expression of these virulence factors. Isolated rat kidneys were perfused with a suspension (5 × 10<sup>4</sup>/ml) of the respective strain or control perfusion medium and the renal functional parameters were analyzed. Intrarenal deposition of <i>E. coli</i> was detected by immunohistology and Gram staining. <i>Results:</i> The perfusion of the isolated perfused rat kidney with a uropathogenic <i>E. coli</i> wild-type strain (536/21 WT) caused an acute deterioration of renal function which was not observed in kidneys exposed to a deletion mutant of <i>E. coli</i> 536/21 lacking the expression of virulence factors. The glomerular filtration rate and the urine flow rate significantly decreased only in kidneys perfused with the <i>E. coli</i> wild-type strain, while there was no change versus controls in kidneys perfused with the deletion mutant. <i>Conclusions:</i> Distinctive bacterial virulence factors different from LPS such as hemolysin and the presence of different fimbriae may contribute to the development of ARF in sepsis induced by <i>E. coli</i>. Anti-LPS strategies may not be sufficient to reduce the risk of ARF in Gram-negative septic shock.