Introduction
Escherichia coli is the major pathogen in many extraintestinal
Gram-negative bacillus infections. Several virulence
factors of E. coli are responsible for colonization and
invasion of the host, and/or serve to avoid or disrupt host
defense mechanisms. Both E. coli virulence characteristics
and host factors contribute to the development of E. coli
bacteremia in upper urinary tract infection (UTI).1
Patients with diabetes mellitus have an increased risk for
infections, including UTI, soft tissue infections, communityacquired
pneumonia, necrotizing otitis externa, and
bloodstream infections.2,3 Impaired host defense, in both
cell-mediated immunity and humoral immunity, increases
the susceptibility to infection. Diabetes-associated functional
and anatomical abnormalities of the host also
contribute to it. Poor glycemic control increases the risk of
community-acquired infections and acquiring asymptomatic
bacteriuria (ABU).4,5 Diabetes with poor glycemic
control and urinary tract obstruction are important host
factors predisposing to emphysematous pyelonephritis.6 In
most E. coli extraintestinal infections, host immunocompetence
is associated with a relatively high prevalence of
papG II, afa and iha, and relatively low antimicrobial
resistance to fluoroquinolones.7
The role of bacterial characteristics and glycemic
control in diabetic patients with E. coli infections related to
urinary tract has not been well investigated. The aims of
this study were to examine and compare the bacterial
characteristics and glycemic control in diabetic patients
with E. coli infections arising in the urinary tract.