Liu Shu-Cheng, Han Xiao-Min, Shi Ming, Pang Zi-Li
Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Urology, Nanhai Hospital, Southern Medical University, Foshan, 528000, China.
J Huazhong Univ Sci Technolog Med Sci. 2016 Oct;36(5):710-715. doi: 10.1007/s11596-016-1649-9. Epub 2016 Oct 18.
This study aimed to provide evidence of persistent uropathogenic Escherichia coli (UPEC) in female patients with recurrent urinary tract infection (UTI) after antibiotic therapy. We collected biopsies of the bladder, and clean-catch urine samples from 32 women who had episodes of recurrent UTI and were given antibiotic therapy. Urine samples and biopsies were analyzed by conventional bacteriological techniques. Phylogenetic group and 16 virulence factors (VFs) of UPEC were determined using polymerase chain reaction (PCR). The infection capability of UPEC was confirmed in a mouse model. Immunofluorescence and electron microscopy were used to detect intracellular bacterial communities (IBCs) in the mouse model. The results showed that all urine specimens were detected sterile. E. coli was found in 6 of 32 biopsies (18.75%), and was identified to be UPEC by PCR. Different VFs associated with the formation of IBCs were identified in all six UPEC isolates. Each UPEC isolate was capable of forming IBCs within the bladder epithelial cells of mice. In conclusion, UPEC with distinctive pathological traits and the capability of IBC formation was first found in the bladders of women after antibiotic therapy, suggesting that the IBC pathogenic pathway may occur in humans and it plays an important role in UTI recurrence.
本研究旨在为抗生素治疗后复发性尿路感染（UTI）女性患者中持续性尿路致病性大肠杆菌（UPEC）的存在提供证据。我们收集了32名有复发性UTI发作且接受过抗生素治疗的女性的膀胱活检组织和清洁中段尿样本。尿液样本和活检组织采用传统细菌学技术进行分析。使用聚合酶链反应（PCR）确定UPEC的系统发育群和16种毒力因子（VFs）。在小鼠模型中证实了UPEC的感染能力。采用免疫荧光和电子显微镜检测小鼠模型中的细胞内细菌群落（IBCs）。结果显示，所有尿液标本检测均无菌。在32份活检组织中的6份（18.75%）发现了大肠杆菌，并通过PCR鉴定为UPEC。在所有6株UPEC分离株中均鉴定出与IBC形成相关的不同VFs。每株UPEC分离株都能够在小鼠膀胱上皮细胞内形成IBCs。总之，首次在抗生素治疗后的女性膀胱中发现了具有独特病理特征和IBC形成能力的UPEC，这表明IBC致病途径可能在人类中发生，并且在UTI复发中起重要作用。
