Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli

Karam, Mohammad Reza Asadi; Habibi, Mehri; Bouzari, Saeid

doi:10.1016/j.molimm.2019.02.007

Cited by 132 publications

(79 citation statements)

References 173 publications

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“…Different types of uropathogenic Escherichia coli (UPEC) strains are considered to be the main causative agents of UTIs that adapted various virulence factors such as flagella, capsule, fimbriae, iron scavenger receptors, lipopolysaccharide, and toxins to cause UTI [39]. Present study showed that most frequently isolated pathogenic strains were E. coli, similar to Hertting et al [40].…”

Section: Discussionsupporting

confidence: 81%

Prevalence and Antibiogram of MDR E. coli Strains Isolated from UTI Patients—1-Year Retrospective Study at Nishtar Medical Hospital, Multan

Fatima

Rafiq

Iqbal

et al. 2020

SN Compr. Clin. Med.

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MDR uropathogens lead to high-level morbidity and mortality and pose a tremendous threat towards treatment failure and survival of UTI patients. This study was conducted to evaluate the demographic characteristics, antibiogram, and resistance pattern of Escherichia coli against antibiotics-a retrospective study at Nishtar Medical Hospital in Multan, from June 2016 to July 2017. A total of 150 clinical samples were collected and biochemically characterized by Berge's manual, and antimicrobial susceptibility testing was performed by using the Kirby-Bauer disc diffusion method and the results were interpreted according to Clinical and Laboratory Standards Institute standards. Data was analyzed by the XL-stat software. Results indicate that UTI was more prevalent in rural areas such as Alipur (28.6%) and Jalalpur (18%) and less common in urban areas like Muzaffargarh (2.66) and Multan (2%). A total of 150 patients were examined, of which 88 were females and 62 males in which more frequently found pathogens were E. coli (33%) and others Klebsiella pneumonia (18%), Proteus (10%), Staphylococcus saprophyticus (8.66%), Staphylococcus aureus (7.33%), Pseudomonas aeruginosa (6.66%), Enterobacter (6%), Candida (5.33%), and Citrobacter (4.66%). The antimicrobial susceptibility testing was carried out against E. coli strains that showed the highest overall resistance patterns of imipenem (IMI), Cip, Aug, Cfm, and CN, which were 80%, 72%, 68%, 60%, and 52%, respectively. MDR E. coli strains showed the highest resistance pattern towards IMI which put through alarming situation in Pakistan. Significant results showed that TZP, AK, and F were found sensitive in vitro against E. coli isolates of UTIs. Prevalence of MDR uropathogens near around Multan has been first time documented in this study with respect to possible risk factors associated with UTI. These alarming signs of MDR E. coli have been rarely addressed and warrant attention on urgent basis.

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Section: Discussionsupporting

confidence: 81%

Prevalence and Antibiogram of MDR E. coli Strains Isolated from UTI Patients—1-Year Retrospective Study at Nishtar Medical Hospital, Multan

Fatima

Rafiq

Iqbal

et al. 2020

SN Compr. Clin. Med.

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“…Other mechanisms of E. coli resistance to quinolones and fluoroquinolones are related to the presence of efflux pumps and decreased uptake of the antibiotics due to changes in the outer membrane porin proteins (Asadi Karam et al 2019). Abdelhamid and Abozahra (2017) showed that the increased expression of the efflux pump-coding genes acrA and mdfA was related to the growing resistance to levofloxacin, which confirms that efflux pump systems contribute to fluoroquinolone resistance in urinary E. coli isolates.…”

Section: Mechanisms Of Upec Resistance To Antibioticsmentioning

confidence: 94%

“…However, ExPEC strains present in other sites such as central nervous system, blood or the urinary tract may cause serious illness. Four main UPEC phylogroups (A, B1, B2, and D) were identified based on the genomic Pathogenicity Islands (PAI) occurrence and strains belonging to B2 and D groups are isolated most frequently from UTI (Kot et al 2016;Asadi Karam et al 2019). The intestinal E. coli enters the urinary tract system and colonizes the periurethral and vaginal areas and the urethra.…”

Section: Escherichia Coli As a Main Etiological Agent Of Utismentioning

confidence: 99%

“…Based on the general European susceptibility patterns and according to the European Association of Urology guidelines, the following antimicrobial agents are recommended for treatment of uncomplicated cystitis in premenopausal women and uncomplicated pyelonephritis in all European countries: nitrofurantoin, fosfomycin trometamol and trimethoprim-sulfamethoxazole (TMP-SMZ) (Bartoletti et al 2016). Nitrofurantoin and fosfomycin trometamol are recommended as first-line therapy for uncomplicated cystitis (Bonkat et al 2017;Asadi Karam et al 2019). TMP-SMZ is not indicated as the empirical treatment due to the high prevalence of bacterial resistance and can be considered only for the patients with a low prevalence of resistant E. coli (< 20%) (Bartoletti et al 2016;Bonkat et al 2017).…”

Section: Treatment Of Utismentioning

confidence: 99%

“…Therefore, ciprofloxacin should be avoided in first-line treatment of UTIs and be used only in more severe infections or as an alternative when the recommended agents cannot be used. Restrictions of ciprofloxacin usage should be enhanced especially in developing countries, where no regulations concerning the use of this antibiotic currently apply (Asadi Karam et al 2019).…”

mentioning

confidence: 99%

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Antibiotic Resistance Among Uropathogenic Escherichia coli

Kot

2019

Polish Journal of Microbiology

162

131

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Urinary tract infections (UTIs) belong to the most common community-acquired and nosocomial infections. A main etiological factor of UTIs is uropathogenic Escherichia coli (UPEC). This review describes the current state of knowledge on the resistance of UPEC to antibiotics recommended for the treatment of UTIs based on the available literature data. Nitrofurantoin and fosfomycin are recommended as first-line therapy in the treatment of uncomplicated cystitis, and the resistance to these antimicrobial agents remains low between UPEC. Recently, in many countries, the increasing resistance is observed to trimethoprim-sulfamethoxazole, which is widely used as the first-line antimicrobial in the treatment of uncomplicated UTIs. In European countries, the resistance of UPEC to this antimicrobial agent ranges from 14.6% to 60%. The widespread use of fluoroquinolones (FQs), especially ciprofloxacin, in the outpatients is the cause of a continuous increase in resistance to these drugs. The resistance of UPEC to FQs is significantly higher in developing countries (55.5–85.5%) than in developed countries (5.1–32.0%). Amoxicillin-clavulanic acid is recommended as first line-therapy for pyelonephritis or complicated UTI. Resistance rates of UPEC to amoxicillin-clavulanic acid are regionally variable. In European countries the level of resistance to this antimicrobial ranges from 5.3% (Germany) to 37.6% (France). Increasing rates of UPEC resistance to antimicrobials indicate that careful monitoring of their use for UTI treatment is necessary.

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Tackling catheter‐associated urinary tract infections with next‐generation antimicrobial technologies

Duque‐Sanchez,

Qu,

Voelcker

et al. 2023

J Biomedical Materials Res

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Urinary catheters and other medical devices associated with the urinary tract such as stents are major contributors to nosocomial urinary tract infections (UTIs) as they provide an access path for pathogens to enter the bladder. Considering that catheter‐associated urinary tract infections (CAUTIs) account for approximately 75% of UTIs and that UTIs represent the most common type of healthcare‐associated infections, novel anti‐infective device technologies are urgently required. The rapid rise of antimicrobial resistance in the context of CAUTIs further highlights the importance of such preventative strategies. In this review, the risk factors for pathogen colonization in the urinary tract are dissected, taking into account the nature and mechanistics of this unique environment. Moreover, the most promising next‐generation preventative strategies are critically assessed, focusing in particular on anti‐infective surface coatings. Finally, emerging approaches in this field and their likely clinical impact are examined.

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Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli

Cited by 132 publications

References 173 publications

Prevalence and Antibiogram of MDR E. coli Strains Isolated from UTI Patients—1-Year Retrospective Study at Nishtar Medical Hospital, Multan

Prevalence and Antibiogram of MDR E. coli Strains Isolated from UTI Patients—1-Year Retrospective Study at Nishtar Medical Hospital, Multan

Antibiotic Resistance Among Uropathogenic Escherichia coli

Tackling catheter‐associated urinary tract infections with next‐generation antimicrobial technologies

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