A 34-year-old woman comes to the physician complaining of fever, dysuria, and flank pain. Her temperature is 37.8 C (100 F), blood pressure is 122/78 mm Hg, and pulse is 84/min. Physical examination elicits suprapubic and costovertebral angle tenderness. Urine dipstick analysis reveals positive leukocyte esterase and nitrite. A subsequent urine culture grows colonies of motile Gram-negative rods demonstrating a green metallic sheen on eosin methylene blue (EMB) agar and hemolysis on blood agar. Which of the following is the most important bacterial factor responsible for this patient's condition?

Question

A 34-year-old woman comes to the physician complaining of fever, dysuria, and flank pain.  Her temperature is 37.8 C (100 F), blood pressure is 122/78 mm Hg, and pulse is 84/min.  Physical examination elicits suprapubic and costovertebral angle tenderness.  Urine dipstick analysis reveals positive leukocyte esterase and nitrite.  A subsequent urine culture grows colonies of motile Gram-negative rods demonstrating a green metallic sheen on eosin methylene blue (EMB) agar and hemolysis on blood agar.  Which of the following is the most important bacterial factor responsible for this patient's condition?

Quizplus · Accepted Answer

Eductional Objective: E coli is one of the dominant components of the normal flora in the intestinal tract of humans and animals.  It causes approximately 80% of all urinary tract infections.  P fimbriae are the most important virulence factor that uropathogenic E coli express.  Without P fimbriae, E coli would not be able to bind to uroepithelial cells and infect the bladder, ureters, and kidneys.  Instead, the bacteria would simply be washed away during urination.

A 34-Year-Old Woman Comes to the Physician Complaining of Fever