Novel Antimicrobial Approaches to Combat Bacterial Biofilms Associated with Urinary Tract Infections

Abstract

Urinary tract infections (UTIs) are prevalent bacterial infections in both community and healthcare settings. They account for approximately 40% of all bacterial infections and require around 15% of all antibiotic prescriptions. Although antibiotics have traditionally been used to treat UTIs for several decades, the significant increase in antibiotic resistance in recent years has made many previously effective treatments ineffective. Biofilm on medical equipment in healthcare settings creates a reservoir of pathogens that can easily be transmitted to patients. Urinary catheter infections are frequently observed in hospitals and are caused by microbes that form a biofilm after a catheter is inserted into the bladder. Managing infections caused by biofilms is challenging due to the emergence of antibiotic resistance. Biofilms enable pathogens to evade the host’s innate immune defences, resulting in long-term persistence. The incidence of sepsis caused by UTIs that have spread to the bloodstream is increasing, and drug-resistant infections may be even more prevalent. While the availability of upcoming tests to identify the bacterial cause of infection and its resistance spectrum is critical, it alone will not solve the problem; innovative treatment approaches are also needed. This review analyses the main characteristics of biofilm formation and drug resistance in recurrent uropathogen-induced UTIs. The importance of innovative and alternative therapies for combatting biofilm-caused UTI is emphasised.

Urinary Tract Infections with Carbapenem-Resistant Klebsiella pneumoniae in a Urology Clinic—A Case-Control Study

“…Neurological disorders were the only comorbidities that occurred more frequently in the study group compared to the control group. The fact that patients in both groups had a high rate of urosepsis on admission, as in other studies [37], demonstrates the aggressiveness of MDR Kpn. However, mortality was lower, demonstrating the better prognosis of urosepsis of urinary origin.…”

“…Numerous studies have demonstrated bacterial colonization of catheters, including with Kpn through its ability to bind to biotic and abiotic surfaces via fimbriae [43]. After fixation, the germs form a bacterial biofilm [26,29,37,44], an element of bacterial persistence and the development of resistance to carbapenems [27]. We have shown that not only does the presence of Foley urethral catheters confer a risk of urinary tract infection with CR Kpn [6], but also the presence of double-J ureteral catheters, nephrostomy, cystostomy, or ureterostomy double-J catheters, as in other studies [26,27,29].…”