{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:10:02Z","timestamp":1762431002522},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,7,29]],"date-time":"2015-07-29T00:00:00Z","timestamp":1438128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Ultrasound and biological tools are used to predict high\u2010grade vesicoureteral reflux, but other markers are needed to better select patients who need voiding cystography. Our aim was to determine whether studying <jats:italic>Escherichia coli<\/jats:italic> virulence factors would help to predict vesicoureteral reflux in patients with their first acute pyelonephritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included children presenting with <jats:italic>E.\u00a0coli<\/jats:italic>\u2010related acute pyelonephritis or cystitis. Vesicoureteral reflux was assessed by voiding cystography. Virulence factors were identified by multiplex polymerase chain reaction. Statistical analysis was performed using logistic regression and the mean c\u2010statistic test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 198 patients: 30 with cystitis and 168 with acute pyelonephritis, including 46 with vesicoureteral reflux. High\u2010grade reflux was associated with acute pyelonephritis caused by the <jats:italic>E.\u00a0coli<\/jats:italic> lacking virulence factors pap<jats:styled-content style=\"fixed-case\">GII<\/jats:styled-content> (82% versus 47%, p\u00a0&lt;\u00a00.001) or papC (85% versus 53%, p\u00a0&lt;\u00a00.001) or belonging to phylogenetic group A or B1. When we added genetic data (lack of pap<jats:styled-content style=\"fixed-case\">GII<\/jats:styled-content>, fyuA and phylogenetic groups) to classical predictors of vesicoureteral reflux (ultrasound examination, gender, age), the ability to predict high\u2010grade reflux increased, with the c\u2010statistic rising from 0.88 to 0.93.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bacterial virulence factors and clinical factors helped to predict high\u2010grade reflux and may help to avoid unnecessary voiding cystographies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.13092","type":"journal-article","created":{"date-parts":[[2015,6,22]],"date-time":"2015-06-22T17:31:26Z","timestamp":1434994286000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<i><scp>E<\/scp>scherichia coli<\/i> virulence patterns may help to predict vesicoureteral reflux in paediatric urinary tract 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