1887

Journal of Medical Microbiology logo

Volume 71, Issue 3

Invasion and diversity in urinary tract infections Open Access

Abstract

is an opportunistic Gram-negative pathogen frequently isolated in urinary tract infections (UTI) affecting elderly and catheterized patients and associated with ineffective antibiotic treatment and poor clinical outcomes.

Invasion has been shown to play an important role in UTI caused by but has only recently been studied with . The ability of to adapt and evolve in chronic lung infections is associated with resistance to antibiotics but has rarely been studied in UTI populations.

We sought to determine whether phenotypic and genotypic heterogeneity exists in UTI isolates and whether, like urinary pathogenic , these could invade human bladder epithelial cells – two factors that could complicate antibiotic treatment.

UTI samples were obtained from five elderly patients at the Royal Liverpool University Hospital as part of routine diagnostics. Fourty isolates from each patient sample were screened for a range of phenotypes. The most phenotypically diverse isolates were genome sequenced. Gentamicin protection assays and confocal microscopy were used to determine capacity to invade bladder epithelial cells.

Despite significant within-patient phenotypic differences, no UTI patient was colonized by distinct strains of . Limited genotypic differences were identified in the form of non-synonymous SNPs. Gentamicin protection assays and confocal microscopy provided evidence of ’s ability to invade bladder epithelial cells.

Phenotypic variation and cell invasion could further complicate antibiotic treatment in some patients. More work is needed to better understand UTI pathogenesis and develop more effective treatment strategies.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): antibiotic resistance , heterogeneity , intracellular , invasion and Urinary tract infection
© 2022 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001458
2022-03-11
2024-04-26
Loading full text...

Full text loading...

/deliver/fulltext/jmm/71/3/jmm001458.html?itemId=/content/journal/jmm/10.1099/jmm.0.001458&mimeType=html&fmt=ahah

References

  1. Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007; 122:160–166 [View Article] [PubMed]
     [Google Scholar]
  2. Foxman B. Epidemiology of urinary tract infections: Incidence, morbidity, and economic costs. Am J Med 2002; 113:5–13 [View Article]
     [Google Scholar]
  3. Lamas Ferreiro JL, Álvarez Otero J, González González L, Novoa Lamazares L, Arca Blanco A et al. Pseudomonas aeruginosa urinary tract infections in hospitalized patients: Mortality and prognostic factors. PLoS ONE 2017; 12: [View Article]
     [Google Scholar]
  4. Gomila A, Carratalà J, Eliakim-Raz N, Shaw E, Wiegand I et al. Risk factors and prognosis of complicated urinary tract infections caused by Pseudomonas aeruginosa in hospitalized patients: a retrospective multicenter cohort study. Infect Drug Resist 2018; 11:2571–2581 [View Article]
     [Google Scholar]
  5. Ironmonger D, Edeghere O, Bains A, Loy R, Woodford N et al. Surveillance of antibiotic susceptibility of urinary tract pathogens for a population of 5.6 million over 4 years. J Antimicrob Chemother 2015; 70:1744–1750 [View Article]
     [Google Scholar]
  6. O’Brien AD, Mulvey MA, Schilling JD, Hultgren SJ. Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection. Infect Immun 2001; 69:4572–4579 [View Article]
     [Google Scholar]
  7. Kroken AR, Chen CK, Evans DJ, Yahr TL, Fleiszig SMJ et al. The iImpact of ExoS on Pseudomonas aeruginosa internalization by epithelial cells is indInternalization by Epithelial Cells Is Independent of fleQ and correlates with bistability of type three secretion system gene exCorrelates with Bistability of Type Three Secretion System Gene Expression. mBio 2018; 9:e00668-18 [View Article]
     [Google Scholar]
  8. Sana TG, Baumann C, Merdes A, Soscia C, Rattei T et al. Internalization of Pseudomonas aeruginosa strain PAO1 into epithelial cells is promoted by interaction of a T6SS effector with the microtubule network. mBio 2015; 6:e00712 [View Article]
     [Google Scholar]
  9. Penaranda C, Chumbler NM, Hung DT, Guillard T. Dual transcriptional analysis reveals adaptation of host and pathogen to intracellular survival of Pseudomonas aeruginosa associated with urinary tract infection. PLoS Pathog 2021; 17:e1009534 [View Article]
     [Google Scholar]
  10. Ashish A, Paterson S, Mowat E, Fothergill JL, Walshaw MJ et al. Extensive diversification is a common feature of Pseudomonas aeruginosa populations during respiratory infections in cystic fibrosis. J Cyst Fibros 2013; 12:790–793 [View Article]
     [Google Scholar]
  11. Evans TJ. Small colony variants of Pseudomonas aeruginosa in chronic bacterial infection of the lung in cystic fibrosis. Future Microbiology 2015; 10:231–239 [View Article]
     [Google Scholar]
  12. Cottalorda A, Leoz M, Dahyot S, Gravey F, Grand M et al. Within-host miHost Microevolution of Pseudomonas aeruginosa urinary isolates: a seven-patient longitudinal genomic and phenotypic sUrinary Isolates: A Seven-Patient Longitudinal Genomic and Phenotypic Study. Front Microbiol 2021; 11:611246 [View Article]
     [Google Scholar]
  13. De Soyza A, Hall AJ, Mahenthiralingam E, Drevinek P, Kaca W et al. Developing an international Pseudomonas aeruginosa reference panel. MicrobiologyOpen 2013; 2:1010–1023 [View Article]
     [Google Scholar]
  14. Floyd RV, Upton M, Hultgren SJ, Wray S, Burdyga TV et al. Escherichia coli-mediated impairment of ureteric contractility is uropathogenic E. coli specific. J Infect Dis 2012; 206:1589–1596 [View Article]
     [Google Scholar]
  15. Matuschek E, Brown DFJ, Kahlmeter G. Development of the EUCAST disk diffusion antimicrobial susceptibility testing method and its implementation in routine microbiology laboratories. Clin Microbiol Infect 2014; 20:255–266 [View Article] [PubMed]
     [Google Scholar]
  16. Fothergill JL, Panagea S, Hart CA, Walshaw MJ, Pitt TL et al. Widespread pyocyanin over-production among isolates of a cystic fibrosis epidemic strain. BMC Microbiol 2007; 7:45 [View Article]
     [Google Scholar]
  17. Yoshimura D, Kajitani R, Gotoh Y, Katahira K, Okuno M et al. Evaluation of SNP calling methods for closely related bacterial isolates and a novel high-accuracy pipeline: BactSNP. Microbial Genomics 2019; 5: [View Article]
     [Google Scholar]
  18. Hilliam Y, Moore MP, Lamont IL, Bilton D, Haworth CS et al. Pseudomonas aeruginosa adaptation and diversification in the non-cystic fibrosis bronchiectasis lung. Eur Respir J 2017; 49:1602108 [View Article]
     [Google Scholar]
  19. Chen SL, Wu M, Henderson JP, Hooton TM, Hibbing ME et al. Genomic diversity and fitness of E. coli strains recovered from the intestinal and urinary tracts of women with recurrent urinary tract infection. Sci Transl Med 2013; 5:184ra60 [View Article]
     [Google Scholar]
  20. Thänert R, Reske KA, Hink T, Wallace MA, Wang B et al. Comparative genomics of antibiotic-resistant uropathogens implicates three routes for recurrence of urinary tract infections. mMBio 2019; 10:e01977-19 [View Article] [PubMed]
     [Google Scholar]
  21. Schwartz DJ, Chen SL, Hultgren SJ, Seed PC, Payne SM. Population dynamics and niche distribution of uropathogenic Escherichia coli during acute and chronic urinary tract infection. Infect Immun 2011; 79:4250–4259 [View Article]
     [Google Scholar]
  22. Yamaguchi T, Yamada H. Role of mechanical injury on airway surface in the pathogenesis of Pseudomonas aeruginosa. Am Rev Respir Dis 1991; 144:1147–1152 [View Article]
     [Google Scholar]
  23. Zahm J-M, Chevillard M, Puchelle E. Wound repair of human surface respiratory epithelium. Am J Respir Cell Mol Biol 1991; 5:242–248 [View Article]
     [Google Scholar]
  24. Tsang KWT, Rutman A, Tanaka E, Lund V, Dewar A et al. Interaction of Pseudomonas aeruginosa with human respiratory mucosa in vitro. Eur Respir J 1994; 7:1746–1753 [View Article]
     [Google Scholar]
  25. de Bentzmann S, Plotkowski C, Puchelle E. Receptors in the pseudomonas aeruginosa adherence to injured and repairing airway epithelium. Am J Respir Crit Care Med 1996; 154:S155–S162 [View Article]
     [Google Scholar]
  26. Geiser TK, Kazmierczak BI, Garrity-Ryan LK, Matthay MA, Engel JN. Pseudomonas aeruginosa ExoT inhibits in vitro lung epithelial wound repair. Cell Microbiol 2001; 3:223–236 [View Article]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001458
Loading
Invasion and diversity in Pseudomonas aeruginosa urinary tract infections
J. Med. Microbiol. 71, 001458 (2022); https://doi.org/10.1099/jmm.0.001458
/content/journal/jmm/10.1099/jmm.0.001458
/content/journal/jmm/10.1099/jmm.0.001458
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error