الفهرس 
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Abstract
The aim of the current study was to compare the impact of Escherichia coli p-fimbrae gene and the chemokine receptor CXCR1 on different studied parameters in APN and ABU patients. In addition, we aimed to assess the impact of CXCR1 gene expression on recurrence risk of APN.
The patients included in this study were inpatient and outpatient children with recurrent pyelonephritis at Military Misr El-Gadeda Hospital. 50 patients (40 females and 10 males) suffering from recurrent pyelonephritis caused by E. coli and 50 controls diagnosed with ABU were enrolled in this study. Urine and blood samples were collected from children aged from 1-11 years old in patients and from 2-12 years old in controls.
For identification of the infecting pathogen, urine samples were collected from all patients and controls, then cultivated on both nutrient and macConkey agar media. The results showed that fifty samples were Escherichia coli isolates and the other bacterial isolates were Klepsiella, pseudomonas, Proteus and Citrobacter.
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Screening the identified isolates for the presence of virulence factors responsible for the pathogenesis of these isolates was then carried out using polymerase chain reaction (PCR). The results revealed that out of fifty samples of Escherichia coli, about forty samples (isolates) were positive for the presence of the adhesive fimbriae (pap G gene), which supports the fact that the presence of this gene may be associated with the infection with pyelonephritis and that explains why it is called pyelonephritis-associated pili. Comparing positive and negative pap APN patients regarding gender, number of recurrences, pus cells, RBCs, total leucocytes, CRP, bacteriuria, duration of fever, admission days and disease related renal scars, did not reveal any significant differences.
Determination of neutrophil CXCR1 gene expression in APN patients was achieved using quantitative real-time PCR analyses (Sybr green RT-qPCR). Data were analyzed with the relative quantification based on the comparative CT method. The results showed that CXCR1 gene expression was found to be significantly (p<0.001) lower in studied APN patients (0.464±0.226) compared to their age matched ABU controls, (1.000±0.428). On the other hand, there were
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no significant correlations between 2^-ΔCT (CXCR1) and neither age, admission days or duration of fever, which may be explained by the limited sample size in the study.
However, a significant negative correlation was found between CXCR1 gene expression and number of recurrences