scholarly journals Enterococcus faecalispromotes innate immune suppression and polymicrobial catheter-associated urinary tract infection

2017 ◽  
Author(s):  
Brenda Yin Qi Tien ◽  
Hwee Mian Sharon Goh ◽  
Kelvin Kian Long Chong ◽  
Soumili Bhaduri-Tagore ◽  
Sarah Holec ◽  
...  

AbstractEnterococcus faecalis, a member of the human gastrointestinal microbiota, is an opportunistic pathogen associated with hospital-acquired wound, bloodstream, and urinary tract infections.E. faecaliscan subvert or evade immune-mediated clearance, although the mechanisms are poorly understood. In this study, we examinedE. faecalis-mediated subversion of macrophage activation. We observed thatE. faecalisactively prevents NF-κB signaling in mouse RAW264.7 macrophages in the presence of Toll-like receptor agonists and during polymicrobial infection withEscherichia coli.E. faecalisandE. colico-infection in a mouse model of catheter-associated urinary tract infection (CAUTI) resulted in a suppressed macrophage transcriptional response in the bladder compared toE. coliinfection alone. Finally, we demonstrated that co-inoculation ofE. faecaliswithE. coliinto catheterized bladders significantly augmentedE. coliCAUTI. Taken together, these results support thatE. faecalissuppression of NF-κB-driven responses in macrophages promotes polymicrobial CAUTI pathogenesis.Author SummarySynergistic polymicrobial infections can contribute to both disease severity and persistence.Enterococcus faecalisandEscherichia coliare frequently co-isolated from polymicrobial urinary tract infections. Immunomodulation by co-infecting microbes can result in a more permissive environment for pathogens to establish infection. Presently, we do not yet understand how these microbes overcome host immunity to establish polymicrobial infections. To address this, we investigated how the immunosuppressive function ofE. faecaliscan contribute to acute infection. We defined thatE. faecalisis able to suppress macrophagesin vitro, despite the presence ofE. coli. We also demonstratedE. faecalis’ability to augmentE. colititersin vivoto establish kidney infection. Our findings raise the prospect thatE. faecaliscan alter host immunity to increase susceptibility to other uropathogens.

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Dong Sup Lee ◽  
Seung-Ju Lee ◽  
Hyun-Sop Choe

Urinary tract infections (UTIs) caused byEscherichia coli (E. coli)are the most common types of infections in women. The antibiotic resistance ofE. coliis increasing rapidly, causing physicians to hesitate when selecting oral antibiotics. In this review, our objective is to ensure that clinicians understand the current seriousness of antibiotic-resistantE. coli, the mechanisms by which resistance is selected for, and methods that can be used to prevent antibiotic resistance.


Author(s):  
Khonaw Kader Salh

Background: The bacteria, Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae), are the main reasons for urinary tract infections (UTIs). This research aimed to investigate the isolation of etiologic agents from patients with UTI; it also investigates the antibiotic resistance activities and incidence of ESBL genes between different clinical separates of uropathogenic E. coli, determining their association with ESBL genes. Methods: The study enrolled 1000 positive growth isolates. The predominant pathogen associated with urinary tract infection, Gram-negative, were the main isolates from UTI patients, including E. coli, K. pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus and Enterococcus faecalis. Results: Among suspicious cases of urinary tract infection, we showed that 15.2% of the patients had UTI, and female patients in the childbearing age group were more affected. 644 E. coli (64.4%) and 322 (32.2%) K. pneumoniae were more isolated. Among 936 (93.6%) ESBL producing bacteria, 614 (61.4 %) E. coli showedhigh resistance to the antibiotics, Cefotaxime (85.7 %), Cefepime (85.7 %), Ciprofloxacin (83.1 %) and Kanamycin (77.9 %). Most ESBL-producing K. pneumoniae were multidrug-resistant (MDR). Nitrofurantoin, gentamycin, and imipenem were the most effective antibiotics for ESBL-producing E. coli isolates. Conclusion: This study shows that the high rates of MDR Escherichia coli infection in our hospital were frequentative reasons for UTI. Nitrofurantoin and aminoglycosides were the most beneficial first-line drugs to be applied in the cases of UTI. It is recommended to conduct regular investigations on the drug resistance of all isolates and formulate helpful antibiotic treatment policies in China. It is important to determine the prevalence of ESBL in urine E. coli and K. pneumoniae isolates because it has a great influence on the selection of suitable antibacterial agents. In short, more than half of ESBL producers have multiple drug resistance (MDR).


mSphere ◽  
2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Reina Yamaji ◽  
Cindy R. Friedman ◽  
Julia Rubin ◽  
Joy Suh ◽  
Erika Thys ◽  
...  

ABSTRACT There is increasing evidence that retail food may serve as a source of Escherichia coli that causes community-acquired urinary tract infections, but the impact of this source in a community is not known. We conducted a prospective, population-based study in one community to examine the frequency of recovery of uropathogenic E. coli genotypes from retail meat samples. We analyzed E. coli isolates from consecutively collected urine samples of patients suspected to have urinary tract infections (UTIs) at a university-affiliated health service and retail meat samples from the same geographic region. We genotyped all E. coli isolates by multilocus sequence typing (MLST) and tested them for antimicrobial susceptibility. From 2016 to 2017, we cultured 233 E. coli isolates from 230 (21%) of 1,087 urine samples and 177 E. coli isolates from 120 (28%) of 427 retail meat samples. Urine samples contained 61 sequence types (STs), and meat samples had 95 STs; 12 STs (ST10, ST38, ST69, ST80, ST88, ST101, ST117, ST131, ST569, ST906, ST1844, and ST2562) were common to both. Thirty-five (81%) of 43 meat isolates among the 12 STs were from poultry. Among 94 isolates in the 12 STs, 26 (60%) of 43 retail meat isolates and 15 (29%) of 51 human isolates were pan-susceptible (P < 0.005). We found that 21% of E. coli isolates from suspected cases of UTIs belonged to STs found in poultry. Poultry may serve as a possible reservoir of uropathogenic E. coli (UPEC). Additional studies are needed to demonstrate transmission pathways of these UPEC genotypes and their food sources. IMPORTANCE Community-acquired urinary tract infection caused by Escherichia coli is one of the most common infectious diseases in the United States, affecting approximately seven million women and costing approximately 11.6 billion dollars annually. In addition, antibiotic resistance among E. coli bacteria causing urinary tract infection continues to increase, which greatly complicates treatment. Identifying sources of uropathogenic E. coli and implementing prevention measures are essential. However, the reservoirs of uropathogenic E. coli have not been well defined. This study demonstrated that poultry sold in retail stores may serve as one possible source of uropathogenic E. coli. This finding adds to a growing body of evidence that suggests that urinary tract infection may be a food-borne disease. More research in this area can lead to the development of preventive strategies to control this common and costly infectious disease.


2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection


2014 ◽  
Vol 27 (3) ◽  
pp. 364 ◽  
Author(s):  
Ana Bispo ◽  
Milene Fernandes ◽  
Cristina Toscano ◽  
Teresa Marques ◽  
Domingos Machado ◽  
...  

<strong>Introduction:</strong> Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients.<br /><strong>Material and Methods:</strong> This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections.<br /><strong>Results:</strong> A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p &lt; 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p &lt; 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the<br />most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions.<br /><strong>Discussion:</strong> Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated.<br /><strong>Conclusion:</strong> Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions.<br /><strong>Keywords:</strong> Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.


2020 ◽  
Author(s):  
Mohammad Hasan Namaei ◽  
Hengameh Hamzei ◽  
Marzie Moghanni ◽  
Azadeh Ebrahimzadeh

Abstract Background: Urinary Tract Infection (UTI) is the most common bacterial infection in the world. E. coli is the predominant Pathogen. This study evaluates the prevalence of ESBL in E. colis isolated from patients with urinary tract infections with phenotypic and genotypic methods.Methods: This descriptive-analytical study was done on 155 isolates of E. coli isolated from patients with urinary tract infection who had received the study consent. After accurate identification of E. coli strains. ESBL production for Escherichia coli isolates which are resistant to ceftriaxone or ceftazidime was evaluated by CDT method. TEM, SHV and CTX-M genes were identified by PCR.Results: The results showed that 30 strains from 155 strains of E. coli had ESBL. Strains of ESBL producer were more in males was lower in educated persons. 38.9% of ESBL producer had antibiotic use, 29.9% -producing Escherichia hospitalization and 31.6% uti history. The highest level of drug allergy in the ESBL was related to nitrofurantoin, and the highest resistance was related to cefazolin, co-trimoxazole. The CTX-M and the CTX-M15 gene were found in 92.7% and 57.1% of cases, respectively; also the SHV and TEM genes were not found in any of ESBL-producing Escherichia coli strains. Most therapeutic response in patients was related to cefexime, ciprofloxacin and nitrofurantoin 27.4%, 26% 21.9%, respectively.Conclusion: This study showed that the history of antibiotic use, hospitalization, uti related to increase of ESBL-producing in E. coli isolates., the CTMX-M gene is the most common gene in ESBL-producing E. coli strains.


2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Arun Giri ◽  
Raju Kafle ◽  
Ganesh Kumar` Singh ◽  
Niraj Niraula

Introduction: Urinary tract infection is one of the commonest causes of childhood morbidity. Earlydiagnosis and appropriate choice of antimicrobials is essential. Hence, this study aims to identify theprevalence of Escherichia coli in childhood urinary tract infections. Methods: This was a hospital based descriptive cross-sectional study conducted in Nobel MedicalCollege, Biratnagar over a period of one year. A total of 163 cases aged 1-15 years were included andclinical profile, laboratory reports including bacterial isolates in urine cultures and their sensitivitypatterns were documented. Results: The prevalence of Escherichia coli is 45 (53.57%) C.I. Escherichia coli was the most commonorganism isolated in bacterial cultures followed by Klebsiella 12 (14.29%), Enterococcus 10 (11.90%).Urinary tract infection was common among females with male: female ratio of 1:2.3. Fever 152(93.2%) and abdominal pain 113 (69.3%) were the most common presenting symptoms. Escherichiacoli was found most sensitive to Nitrofurantoin 43 (95.5%) followed by Ciprofloxacin 41 (91.1%) andAmikacin 40 (88.8%). Conclusions: Urinary tract infections in childhood require prompt attention and treatment to preventsignificant morbidity and mortality. From this study it can be concluded that Escherichia coli is oneof the most common isolates in urine culture and Aminoglycosides and Fluoroquinolones can beaccepted as empirical treatment regimens for childhood Urinary tract infections.


Author(s):  
Alaa Abood Yasir OKAB ◽  
Manal B SALIH

Escherichia coli (E. coli) is the most common type of pathogen that causes Urinary tract infection disease. It can be presented as a pathogenic or non-pathogenic strain and found not only in the animal but also in the human intestine. This bacterium can cause opportunistic infection when the human host comprised of thalassemia patients or changes the healthy hemostatic flora. This study aimed to analyze the presence of bacteria in thalassemia patients with urinary tract infection. A total of 303 samples were collected during the period from August 2019 to January 2020 from thalassemia patients who suffered from urinary tract infection. The results showed that there were 6.9% of patients infected with E. coli, 2.6% of patients were infected with S. aureus, 0.7% with both Proteus and Klebsiella, while 89.1% of patients had a negative sample for bacteria. Also, the incidence of urinary tract infections in females is higher than in males. Besides, its occurrence in rural areas is higher than in city residents. Moreover, among 16 antibiotics tested to sensitize bacteria to antibiotics, Imipenem showed 100% efficacy on all isolated bacteria. In contrast, Netilmicin showed 80.1% efficacy, Gentamycin 80.1%, and Amikacin 76.2%. Ampicillin, Aztreonam, Amoxicillin-Clavulanic Acid, Tetracycline, and Ticarcillin-Clavulanic Acid, did not show any effectiveness toward the bacteria while other antibiotics showed different activities. Furthermore, the isolated microbes from thalassemia patients were the highest resistance to antibiotics in comparison with other studies, and this antibiotic-resistant may be due to the weakening of the patient's immune status and frequent blood taking and the antibodies it contains.


2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Shima Sadat Lesani ◽  
Mohammad Soleimani ◽  
Pegah Shakib ◽  
Mohammad Reza Zolfaghari

Background: Escherichia coli is considered as one of the causes of opportunistic infections. Nowadays, due to the increase in drug resistance, the treatment of these infections has become very difficult and they are recognized as the main causes of death in hospitalized patients. Objectives: The aim of this study was to determine the prevalence of blaTEM, blaSHV, and blaCTX-M genes in E. coli strains isolated from the urinary tract infection in patients in Intensive Care Units of three different hospitals in Qom, Iran. Methods: This study was conducted in three months from October to December 2014. A total of 200 E. coli samples were taken from the patients with urinary tract infections in Intensive Care units of Qom hospital. The disc diffusion method was used to determine the susceptibility pattern of antibiotic and phenotypic confirmatory tests for screening of the expanded spectrum beta-lactamase (ESBL) isolates. The presence of blaTEM, blaSHV, and blaCTX-M genes was evaluated by the polymerase chain reaction (PCR) assay. Results: Of 200 samples, ampicillin (96%) and nitrofurantoin (19.5%) showed the highest and lowest drug resistance, respectively. A total of 156 isolates (78%) were identified as ESBLs using the phenotypic method. Moreover, 76 (38%), 90 (45%), and 123 (61.5%) isolates consisted of blaCTX-M, blaSHV, and blaTEM, respectively. Conclusions: Overall, the findings of this study showed that blaTEM was the most common gene with a frequency of 61.5% in ESBL E. coli.


1997 ◽  
Vol 3 (2) ◽  
pp. 290-295
Author(s):  
Shahab Modarres ◽  
Navideh Nassiri Oskoii

The bacterial agents of urinary tract infections were studied in 1650 children under 12 years of age between April 1993 and March 1995. It was found that 25.8% [425/1650] of infants and children showed bacteriuria [>10 [5] bacteria per millilitre of urine]. Escherichia coli was responsible for 71.0% of all infections. Infections caused by Proteus spp. were predominantly found in boys. Girls showed a higher prevalence of infection [35.3%] than boys [18.3%], which was statistically highly significant [P < 0.001]. The most commonly isolated bacteria were partially or totally sensitive to the aminoglycosides, chloramphenicol and nalidixic acid


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