Biofilm formation by asymptomatic and virulent urinary tract infectious Escherichia coli strains

Escherichia coli is the most common organism associated with asymptomatic bacteriuria (ABU) in humans. In contrast to uropathogenic E. coli (UPEC) that cause symptomatic urinary tract infection, very little is known about the mechanisms by which these strains colonize the urinary tract. Here, we have investigated the biofilm-forming capacity on abiotic surfaces of groups of ABU strains and UPEC strains in human urine. We found that there is a strong bias; ABU strains were significantly better biofilm formers than UPEC strains. Our data suggest that biofilm formation in urinary tract infectious E. coli seems to be associated with ABU strains and appears to be an important strategy used by these strains for persistence in this high-flow environment.     

Specific selection for virulent urinary tract infectious Escherichia coli strains during catheter-associated biofilm formation

Biofilm-associated bacterial infections have a major impact on artificial implants such as urinary catheters, often with devastating consequences. The capacity of a microorganism to form a biofilm on a surface depends on the nature of the surface and its conditioning. When a urinary catheter is exposed to urine, various components adsorb onto the surface and form a conditioning film, which becomes the real interface where microbial interaction takes place. It follows that the material constituting the catheter determines the composition of the conditioning film, which in turn influences which microorganisms can attach. Urinary tract infectious (UTI) Escherichia coli range in pathogenicity and the damage they cause--from benign asymptomatic bacteriuria (ABU) strains, which inflict no or few problems to the host, to uropathogenic E. coli (UPEC) strains, which are virulent and often cause severe symptoms and complications. We have found that whereas ABU strains produce better biofilms on polystyrene and glass, UPEC strains have a clear competitive advantage during biofilm growth on catheter surfaces. Our results indicate that some silicone and silicone-latex catheters actually select for and promote biofilm formation of the most virulent group of UTI E. coli strains, hardly a desirable situation for the catheterized patient.     

Rapid immunodetection of Escherichia coli

A filtration flow-through design was used to develop the rapid immunodetection of Escherichia coli. Polyclonal anti-E. coli IgG was conjugated to small, 0.8 Blue latex beads. Cells were mixed with conjugated beads in the presence of anti-E. coli monoclonal IgM. The suspension was then filtered through a 5 nitrocellulose membrane. The cell-containing complexes were effectively collected on the filter, forming a blue spot. The method produced reliable detection of E. coli at a concentration of 10⁵ cells ml^–1, which is a current benchmark figure for urinary tract infection (UTI) diagnosis.     

Diffusely adherent Escherichia coli strains expressing Afa/Dr adhesins (Afa/Dr DAEC): hitherto unrecognized pathogens

Diffusely adherent Escherichia coli (DAEC) strains are currently considered to constitute a putative sixth group of diarrheagenic E. coli. However, on the basis of their diffuse adherence to HEp-2 and HeLa cells, the detection of afa/dra/daa-related operons encoding this adherence phenotype, and the mobilization of decay-accelerating factor, both commensal and pathogenic strains can be classified as Afa/Dr DAEC isolates. Furthermore, strains associated with diarrheal diseases and strains causing extra-intestinal infections can also be identified as Afa/Dr DAEC strains. Although several cell signaling events that occur after epithelial cells have been infected by Afa/Dr DAEC have been reported, the pathophysiological processes that allow intestinal and extra-intestinal infections to develop are not fully understood. This review focuses on the genetic organization of the afa/dra/daa-related operons and on the virulence factors that trigger cellular responses, some of which are deleterious for the host cells. Finally, this review suggests future lines of research that could help to elucidate these questions.     

Isolation and characterisation of dog uropathogenic Escherichia coli strains and their fimbriae

A number of Escherichia coli strains have been isolated from dogs with urinary tract infections. These strains have been characterised with respect to their O, K, H, and fimbrial antigens, colicin production, antibiotic resistance, plasmid content and their ability to haemagglutinate erythrocytes from various species. Crossed immunoelectrophoresis of fimbrial extracts, as well as the reaction of partly purified fimbriae of a number of these strains with monoclonal antibodies revealed homology or a strong crossereaction with an F12 fimbrial subunit protein of human uropathogenic E. coli strains. Unlike human F12 fimbriae producing strains, the dog isolates did agglutinate dog erythrocytes in the presence of D-mannose but not human erythrocytes, indicating that the adhesin carried by these strains is different from the adhesin on fimbriae of human uropathogenic E. coli. Similar indications were obtained from experiments with latex beads coated with the receptor for P-fimbriae. These beads were agglutinated by Escherichia coli strains from human urinary tract infections, but not by the dog isolates described here. Preliminary adhesion experiments of human and dog Escherichia coli to human bladder epithelial and canine kidney epithelial cells also showed differences in adhesion depending on the origin of the strain tested.     

P fimbriae on uropathogenic Escherichia coli O16:K1 and O18 strains

Abstract The fimbrial composition of 12 P-fimbriate uropathogenic Escherichia coli O16 and O18 strains was analysed by immunoprecipitation with 14 fimbria-specific antisera. All the O16 strains possessed a P fimbrial serovariant with an apparent M _r of 17500. One strain had an additional, serologically closely related P fimbria with an apparent M _r of 19 800. Two groups were found among the O18 strains; one possessing a type 1C fimbria and a 19800-Da P fimbria, the other lacking type 1C fimbriae and possessing a P-fimbrial variant with an apparent M _r of 17 800. Fimbriae on strains within the groups were serologically similar by immunoprecipitation assays. Also, the fimbriae on the O16 and O18 strains were mutually cross-reactive. The grouping of the O18 strains by fimbrial serology corresponded to the previous clonal grouping based on other phenotypic characters.     

Escherichia coli outer membrane protease OmpT confers resistance to urinary cationic peptides

Escherichia coli OmpT, located in the outer membrane, has been characterized as a plasminogen activator, with the ability to hydrolyze protamine and block its entry. In this investigation, a complex of low molecular weight cationic peptides purified from human urine by a combination of membrane ultrafiltration and weak cation exchange chromatography was characterized. The impact of OmpT on E. coli resistance to urinary cationic peptides was investigated by testing ompT knockout strains. The ompT mutants were more susceptible to urinary cationic peptides than ompT⁺ strains, and this difference was abolished by complementation of the mutants with pUC19 carrying the ompT gene. The urinary protease inhibitor ulinastatin greatly decreased the resistance of the ompT⁺ strains. Overall, the data indicate that OmpT may help E. coli persist longer in the urinary tract by enabling it to resist the antimicrobial activity of urinary cationic peptides.     

Role of cranberry juice on molecular-scale surface characteristics and adhesion behavior of Escherichia coli

Cranberry juice has long been believed to benefit the prevention and treatment of urinary tract infections (UTIs). As the first step in the development of infection, bacterial adhesion is of great research interest, yet few studies have addressed molecular level adhesion in this context. P-fimbriated Escherichia coli play a major role in the development of a serious type of UTI, acute pyelonephritis. Experiments were conducted to investigate the molecular-scale effects of cranberry juice on two E. coli strains: HB101, which has no fimbriae, and the mutant HB101pDC1 which expresses P-fimbriae. Atomic force microscopy (AFM) was used to investigate both bacterial surface characteristics and adhesion forces between a probe surface (silicon nitride) and the bacteria, providing a direct evaluation of bacterial adhesion and interaction forces. Cranberry juice affected bacterial surface polymer and adhesion behavior after a short exposure period (<3 h). Cranberry juice affected the P-fimbriated bacteria by decreasing the adhesion forces between the bacterium and tip and by altering the conformation of the surface macromolecules on E. coli HB101pDC1. The equilibrium length of polymer (P-fimbriae) on this bacterium decreased from approximately 148 to approximately 48 nm upon being exposed to cranberry juice. Highly acidic conditions were not necessary for the prevention of bacterial adhesion, since neutralization of cranberry juice solutions to pH = 7.0 allowed us to observe differences in adhesion between the E. coli strains. Our results demonstrate molecular-level changes in the surfaces of P-fimbriated E. coli upon exposure to neutralized cranberry juice.     

Role of collectin-11 in innate defence against uropathogenic Escherichia coli infection

Classical collectins (surfactant protein A and D) play a significant role in innate immunity and host defence in uropathogenic Escherichia coli (UPEC)-induced urinary tract infection (UTI). However, the functions of collectin-11 (CL-11) with respect to UPEC and UTI remain largely unexplored. This study aimed to investigate the effect of CL-11 on UPEC and its role in UTI. We further examined its modulatory effect on inflammatory reactions in proximal tubular epithelial cells (PTECs). The present study provides evidence for the effect of CL-11 on the growth, agglutination, binding, epithelial adhesion and invasion of UPEC. We found increased basal levels of phosphorylated p38 MAPK and human cytokine homologue (keratinocyte-derived chemokine) expression in CL-11 knockdown PTECs. Furthermore, signal regulatory protein α blockade reversed the increased basal levels of inflammation associated with CL-11 knockdown in PTECs. Additionally, CL-11 knockdown effectively inhibited UPEC-induced p38 MAPK phosphorylation and cytokine production in PTECs. These were further inhibited by CD91 blockade. We conclude that CL-11 functions as a mediator of innate immunity via direct antibacterial roles as well as dual modulatory roles in UPEC-induced inflammatory responses during UTI. Thus, the study findings suggest a possible function for CL-11 in defence against UTI.     

Prevalence of virulence genes in Escherichia coli strains isolated from Romanian adult urinary tract infection cases

A total of 78 E. coli strains isolated from adults with different types of urinary tract infections were screened by polymerase chain reaction for prevalence of genetic regions coding for virulence factors. The targeted genetic determinants were those coding for type 1 fimbriae ( fimH ), pili associated with pyelonephritis ( pap ), S and F1C fimbriae ( sfa and foc ), afimbrial adhesins ( afa ), hemolysin ( hly ), cytotoxic necrotizing factor ( cnf ), aerobactin ( aer ). Among the studied strains, the prevalence of genes coding for fimbrial adhesive systems was 86 %, 36%, and 23% for fimH, pap , and sfa/foc , respectively. The operons coding for Afa afimbrial adhesins were identified in 14% of strains. The hly and cnf genes coding for toxins were amplified in 23% and 13% of strains, respectively. A prevalence of 54% was found for the aer gene. The various combinations of detected genes were designated as virulence patterns. The strains isolated from the hospitalized patients displayed a greater number of virulence genes and a diversity of gene associations compared to the strains isolated from the ambulatory subjects. A rapid assessment of the bacterial pathogenicity characteristics may contribute to a better medical approach of the patients with urinary tract infections.     

Distribution of virulence profiles related to new toxins and putative adhesins in Shiga toxin-producing Escherichia coli isolated from diverse sources in Brazil

The distribution of virulence markers related to cytolethal distending toxin-V (CDT-V), subtilase cytotoxin (SubAB), the enterohemorrhagic Escherichia coli factor for adherence (Efa1), the adhesin similar to IrgA (Iha), the long polar fimbriae (LpfO113), the autoagglutinating adhesin (Saa), and the protein required for full expression of adherence of O157:H7 Sakai strain (ToxB) was investigated in 121 Shiga toxin-producing E. coli (STEC) strains isolated in Brazil. STEC strains were isolated from human infections (n=49), cattle (n=68) and ground meat samples (n=4). Overall, the lpfA(O113), iha, efa1, saa, and toxB sequences were observed in 89.2%, 87.6%, 47.1%, 43%, and 13.2% of the strains, respectively. The genes efa1 (96.6%) and toxB (27%) were only identified among eae-positive strains, while saa (83.8%), cdt-V (12.9%), and subAB (48.4%) just occurred in eae-negative STEC strains. STEC strains harboring cdt-V and subAB were for the first time described in the South American subcontinent. In addition, the simultaneous presence of cdt-V and subAB has not been previously reported, nor the presence of subAB in STEC O77, O79, O105, O174, and O178 serogroups. A diversity of virulence profiles was observed among the STEC strains studied. The most prevalent profile observed among eae-positive STEC strains mainly isolated from humans was eae efa1 iha lpfA(O113), whereas iha lpfA(O113) saa ehxA subAB prevailed among eae-negative STEC strains, mostly isolated from cattle and foods.     

辽宁省2017年至2021年尿培养主要病原菌分布及临床意义

泌尿系统感染的临床发病率很高,仅次于呼吸系统感染。对分离的细菌进行鉴定以及药敏试验,有助于了解引起感染的各种细菌分布以及耐药情况。研究患者尿培养病原菌的分布以及临床常用抗生素耐药情况,从而为临床正确、合理使用药物提供参考。回顾分析了辽宁省2017年1月至2021年12月共4 865份尿标本感染菌鉴定结果和大肠埃希菌（Escherichia coli）的药物敏感试验结果,数据来自辽宁省各大医院。采用法国梅里埃VITEK MS全自动快速微生物质谱检测系统和/或VITEK 2 Compact全自动微生物鉴定仪进行菌种鉴定,对来自门诊和住院泌尿系统感染患者尿标本中分离的1 411株大肠埃希菌进行药敏试验分析。结果表明,尿培养的病原菌中主要以革兰阴性菌为主占66.2％,其次为革兰阳性菌。在革兰阴性菌当中大肠埃希菌占37.1%。大肠埃希菌对氨苄西林、环丙沙星、复方新诺明、头孢唑啉的耐药性比较高,每年的耐药率均超过50%,对哌拉西林的耐药率在2021年已经达到100%。而对于阿米卡星、呋喃妥英、美罗培南、哌拉西林/他唑巴坦、头孢替坦和亚胺培南则出现较低的耐药性,五年的耐药率均低于10%。对于临床治疗尿路感染选用的左氧氟沙星、头孢呋辛和头孢曲松三个一线药物,大肠埃希菌对左氧氟沙星的耐药率有逐年上升的趋势,但对头孢呋辛和头孢曲松的耐药率变化不大。上述结果表明,辽宁省近五年尿培养的主要致病菌是革兰阴性菌,其中大肠埃希菌占有的比例很高。大肠埃希菌易产生耐药性,需对其加强监测,通过向临床提供最新最快的耐药性分析资料,可以更好地控制大肠埃希菌导致的感染,为临床合理用药及治疗提供帮助。     

Assessment of the Significance of Virulence Factors of Uropathogenic Escherichia coli in Experimental Urinary Tract Infection in Mice

Four Escherichia coli strains, isolated from cystitis patients, belonging to serotype O2:H^? and possessing different combinations of urovirulence factors were examined in an experimental pyelonephritis mouse model to assess the relative importance of virulence factors in causation of urinary tract infections (UTI). The results suggest not only that the each virulence factor has a role in causation of UTI but also that the presence of P fimbriae and production of hemolysin significantly reduced the LD₅₀ and ID₅₀ of the strains in the mouse model. The results also demonstrate that the presence of additional virulence factors acts in an additive or synergetic fashion enhancing the cumulative impact of the strain.