MR/K Hemagglutination of Providencia stuartii Correlates with Adherence to Catheters and with Persistence in Catheter-Associated Bacteriuria

Mobley, Harry L. T.; Chippendale, G. R.; Tenney, James H.; Mayrer, Andrew R.; Crisp, L J; Penner, J L; Warren, John W.

doi:10.1093/infdis/157.2.264

Cited by 79 publications

(40 citation statements)

References 25 publications

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“…Since type 3 fimbriae mediate biofilm formation, it is altogether plausible that type 3 fimbriae play a significant role in biofilm-associated infections. Indeed, expression of type 3 fimbriae has previously been shown to correlate with long-term persistence of Providencia stuartii in patients with catheterassociated bacteriuria (32). Therefore, although the present study indicates that type 3 fimbriae are not a virulence factor in uncomplicated K. pneumoniae infections, the expression of type 3 fimbriae may play an important role in development of infections in catheterized patients.…”

Section: Discussioncontrasting

confidence: 57%

Identification of a Conserved Chromosomal Region Encoding Klebsiella pneumoniae Type 1 and Type 3 Fimbriae and Assessment of the Role of Fimbriae in Pathogenicity

2009

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Type 3 fimbriae are expressed by most clinical Klebsiella pneumoniae isolates and mediate adhesion to host structures in vitro. However, the role of type 3 fimbriae in K. pneumoniae virulence has not been evaluated by use of in vivo infection models. In this study, the type 3 fimbrial gene cluster (mrk) of the clinical isolate C3091 is described in detail. The mrk gene cluster was revealed to be localized in close proximity to the type 1 fimbrial gene cluster. Thus, a 20.4-kb fimbria-encoding region was identified and found to be highly conserved among different K. pneumoniae isolates. Interestingly, a homologue to PecS, known as a global regulator of virulence in Erwinia chrysanthemi, was identified in the fimbria-encoding region. Comparison to the previously characterized plasmid encoded mrk gene cluster revealed significant differences, and it is established here that the putative regulatory gene mrkE is not a part of the chromosomally encoded type 3 fimbrial gene cluster. To evaluate the role of type 3 fimbriae in virulence, a type 3 fimbria mutant and a type 1 and type 3 fimbria double mutant was constructed. Type 3 fimbria expression was found to strongly promote biofilm formation. However, the fimbria mutants were as effective at colonizing the intestine as the wild type, and their virulence was not attenuated in a lung infection model. Also, in a urinary tract infection model, type 3 fimbriae did not influence the virulence, whereas type 1 fimbriae were verified as an essential virulence factor. Thus, type 3 fimbriae were established not to be a virulence factor in uncomplicated K. pneumoniae infections. However, since type 3 fimbriae promote biofilm formation, their role in development of infections in catheterized patients needs to be elucidated.

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Section: Discussioncontrasting

confidence: 57%

Identification of a Conserved Chromosomal Region Encoding Klebsiella pneumoniae Type 1 and Type 3 Fimbriae and Assessment of the Role of Fimbriae in Pathogenicity

2009

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“…A multifunctional role of bacterial fimbriae has previously been suggested by Korhonen and his group (16). Type 3 fimbriae are produced by many members of the Enterobacteriaceae that are associated with opportunistic infections (1,19,20). The ability to form biofilms on the surfaces of implants and catheters could be critical to the survival of these bacteria in vivo.…”

Section: Discussionmentioning

confidence: 99%

Type 3 Fimbrial Shaft (MrkA) of Klebsiella pneumoniae , but Not the Fimbrial Adhesin (MrkD), Facilitates Biofilm Formation

2001

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Isolates of Klebsiella pneumoniae are responsible for opportunistic infections, particularly of the urinary tract and respiratory tract, in humans. These bacteria express type 3 fimbriae that have been implicated in binding to eucaryotic cells and matrix proteins. The type 3 fimbriae mediate binding to target tissue using the MrkD adhesin that is associated with the fimbrial shaft comprised of the MrkA protein. The formation of biofilms in vitro by strains of K. pneumoniae was shown to be affected by the production of fimbriae on the bacterial surface. However, a functional MrkD adhesin was not necessary for efficient biofilm formation. Nonfimbriate strains were impaired in their ability to form biofilms. Using isogenic fimbriate and nonfimbriate strains of K. pneumoniae expressing green fluorescent protein it was possible to demonstrate that the presence of type 3 fimbriae facilitated the formation of dense biofilms in a continuous-flowthrough chamber. Transformation of nonfimbriate mutants with a plasmid possessing an intact mrk gene cluster restored the fimbrial phenotype and the rapid ability to form biofilms.

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“…On the other hand, MR/K fimbriae have been linked with the attachment of organisms to catheter surfaces and with the persistence of catheter-associated bacteriuria (262,331,461). These fimbriae have also been detected during Providencia stuartii infections in catheterized elderly patients (262).…”

Section: Adhesinsmentioning

confidence: 99%

Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

et al. 2008

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SUMMARY Catheter-associated urinary tract infections (CAUTIs) represent the most common type of nosocomial infection and are a major health concern due to the complications and frequent recurrence. These infections are often caused by Escherichia coli and Proteus mirabilis. Gram-negative bacterial species that cause CAUTIs express a number of virulence factors associated with adhesion, motility, biofilm formation, immunoavoidance, and nutrient acquisition as well as factors that cause damage to the host. These infections can be reduced by limiting catheter usage and ensuring that health care professionals correctly use closed-system Foley catheters. A number of novel approaches such as condom and suprapubic catheters, intermittent catheterization, new surfaces, catheters with antimicrobial agents, and probiotics have thus far met with limited success. While the diagnosis of symptomatic versus asymptomatic CAUTIs may be a contentious issue, it is generally agreed that once a catheterized patient is believed to have a symptomatic urinary tract infection, the catheter is removed if possible due to the high rate of relapse. Research focusing on the pathogenesis of CAUTIs will lead to a better understanding of the disease process and will subsequently lead to the development of new diagnosis, prevention, and treatment options.

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MR/K Hemagglutination of Providencia stuartii Correlates with Adherence to Catheters and with Persistence in Catheter-Associated Bacteriuria

Cited by 79 publications

References 25 publications

Identification of a Conserved Chromosomal Region Encoding Klebsiella pneumoniae Type 1 and Type 3 Fimbriae and Assessment of the Role of Fimbriae in Pathogenicity

Identification of a Conserved Chromosomal Region Encoding Klebsiella pneumoniae Type 1 and Type 3 Fimbriae and Assessment of the Role of Fimbriae in Pathogenicity

Type 3 Fimbrial Shaft (MrkA) of Klebsiella pneumoniae , but Not the Fimbrial Adhesin (MrkD), Facilitates Biofilm Formation

Complicated Catheter-Associated Urinary Tract Infections Due toEscherichia coliandProteus mirabilis

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