Molecular Factors and Mechanisms Driving Multidrug Resistance in Uropathogenic Escherichia coli—An Update

Abstract

The rapid emergence of multidrug-resistant (MDR) bacteria indisputably constitutes a major global health problem. Pathogenic Escherichia coli are listed among the most critical group of bacteria that require fast development of new antibiotics and innovative treatment strategies. Among harmful extraintestinal Enterobacteriaceae strains, uropathogenic E. coli (UPEC) pose a significant health threat. UPEC are considered the major causative factor of urinary tract infection (UTI), the second-most commonly diagnosed infectious disease in humans worldwide. UTI treatment places a substantial financial burden on healthcare systems. Most importantly, the misuse of antibiotics during treatment has caused selection of strains with the ability to acquire MDR via miscellaneous mechanisms resulting in gaining resistance against many commonly prescribed antibiotics like ampicillin, gentamicin, cotrimoxazole and quinolones. Mobile genetic elements (MGEs) such as transposons, integrons and conjugative plasmids are the major drivers in spreading resistance genes in UPEC. The co-occurrence of various bacterial evasion strategies involving MGEs and the SOS stress response system requires further research and can potentially lead to the discovery of new, much-awaited therapeutic targets. Here, we analyzed and summarized recent discoveries regarding the role, mechanisms, and perspectives of MDR in the pathogenicity of UPEC.

Analysis of the Distribution and Drug Resistance of Pathogens in Patients with Urinary Tract Infection in the Eastern Chongming Area of Shanghai from 2018 to 2020

“… 10 , 11 In addition, multidrug-resistant bacteria can transfer genetic elements between bacterial cells, or even the concerted activities of mobile genetic elements that can move within or between DNA molecules, facilitating the acquisition and spread of resistance genes. 12 , 13 The predicted prevalence of multidrug-resistant E. coli resistance by 2030 is 77%. 14 Coincidentally, the global change in gram-positive bacteria is equally worrying.…”

Possible step-up in prevalence for Escherichia coli ST131 from fecal to clinical isolates: inferred virulence potential comparative studies within phylogenetic group B2

“…Moreover, FQ-R ST131 clinical ESBL producing isolates harbored on average more VF genes than all other isolates. Thus, the present study demonstrates that FQ-resistance and a plurality of VF genes can exist together, something that has traditionally been regarded as inversely related [ 32 ]. These findings confirm, from a different population and geographical location, previous findings [ 26 , 27 ] and provide possible explanation for the remarkable success of ST131 as a pathogen, including group B2 phylogenetic background, plurality of VF genes and antimicrobial resistance [ 2 ].…”

Intimin (eae) and virulence membrane protein pagC genes are associated with biofilm formation and multidrug resistance in Escherichia coli and Salmonella enterica isolates from calves with diarrhea

“…In recent years, numerous MDR isolates of E. coli and S. enterica have been reported from several countries [ 31 – 33 ]. Both pathogens utilize multiple antibiotic resistance mechanisms including mobile genetic elements, integrons, plasmids, and efflux pumps [ 35 , 36 ].…”