Urinary Tract Infection Molecular Mechanisms and Clinical Translation

Abstract

Rapid developments in infection biology create new and exciting options for individualized diagnostics and therapy. Such new practices are needed to improve patient survival and reduce morbidity. Molecular determinants of host resistance to infection are being characterized, making it possible to identify susceptible individuals and to predict their risk for future morbidity. Immunotherapy is emerging as a new strategy to treat infections worldwide and controlled boosting of the host immune defense represents an important therapeutic alternative to antibiotics. In proof of concept studies, we have demonstrated that this approach is feasible. The long-term goal is not just to remove the pathogens but to also develop technologies that restore resistance to infection in disease-prone patients and devise personalized therapeutic interventions. Here, we discuss some approaches to reaching these goals, in patients with urinary tract infection (UTI). We describe critical host signaling pathways that define symptoms and pathology and the genetic control of innate immune responses that balance protection against tissue damage. For some of these genes, human relevance has been documented in clinical studies, identifying them as potential targets for immune-modulatory therapies, as a complement to antibiotics.

Genetic diversity and biofilm formation analysis of Staphylococcus aureus causing urinary tract infections in Tehran, Iran

“…Urinary tract infections (UTIs) are a significant health problem in both community and health care settings, annually affecting more than 150 million people around the world [1]. Although it is well established that UTIs occur more often in women than in men, it seems that almost all individuals experience at least one episode of UTI during their lifetime [2].…”

“…A wide variety of organisms, including Gram-negative and Gram-positive bacteria, as well as certain fungi, are known to cause UTIs. Although the most common causative agents are Escherichia coli, Klebsiella pneumonia and other Enterobacteriaceae, the role of Staphylococcus aureus (S. aureus) in relation to UTI should not be overlooked [1][2][3]. Although S. aureus is responsible for 0.5-6% of UTI cases, antibiotic therapy in symptomatic UTI related to this species is highly recommended and must be considered [4].…”

SCCmec and spa Typing of Staphylococcus aureus Strains Isolated from Patients with Urinary Tract Infection: Emergence of spa Types t426 and t021 in Iran

“…Although Escherichia coli and other Enterobacteriacae are the most important causes of UTIs, such infections could be caused by different bacteria (1). Recently, several investigators have evaluated the presence of Gram positive species, such as coagulase negative staphylococci, Staphylococcus aureus, Streptococcus group B, and enterococci, which play a clinically significant role in UTIs.…”

“…in cases of endocarditis), it could be an important primary urinary pathogen and causes ascending urinary tract colonization and infection (1,2). The most important factor contributing to the successful wide distribution of this pathogen is believed to be the remarkable ability to acquire resistance to antimicrobial agents, to the extent that, nowadays, one of the major public health concerns regarding S. aureus infections is the increasing prevalence of methicillin-resistant S. aureus (MRSA) (3)(4)(5).…”

“…Increased antibiotic resistance has significantly limited the choice of therapeutic options available for treatment of staphylococcal infections and presents a particularly difficult challenge in these contexts (2). Due to rapid dissemination of MRSA and multi drug resistance (MDR), therapeutic options are limited when staphylococcal UTI is encountered; therefore, UTI caused by S. aureus requires special management (1,2).…”