KEYWORDS
Bacterial virulence;
Diabetes mellitus;
Escherichia coli;
Glycemic control;
Urinary tract
infection
Background: Patients with diabetes mellitus have an increased risk of infection. The roles of
bacterial characteristics and glycemic control in diabetic patients with Escherichia coli infection
have not been well investigated. The aims of this study were to examine the bacterial
characteristics and glycemic control in diabetic patients with E. coli infections arising in the
urinary tract.
Methods: A total of 271 E. coli isolates were collected from urine and bloodstream. Phylogenetic
groups, the presence of virulence genes, and antimicrobial susceptibility of E. coli
isolates were determined.
Results: There were few differences in E. coli bacterial characteristics between 190 diabetic
and 81 nondiabetic patients. In diabetic patients with urosepsis, there was a higher hemoglobin
A1C level, and the related E. coli strains had more neuA, papG II, afa and hlyA genes,
and a lower prevalence of antimicrobial resistance to cephalosporins and fluoroquinolones
than those with asymptomatic bacteriuria and urinary tract infection. Multivariate logistic
regression analysis revealed that increased hemoglobin A1C and presence of papG II and afa