Azevedo Andreia S, Almeida Carina, Melo Luís F, Azevedo Nuno F
a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal.
b Institute for Biotechnology and Bioengineering (IBB), Centre of Biological Engineering, Universidade do Minho , Braga , Portugal.
Crit Rev Microbiol. 2017 Aug;43(4):423-439. doi: 10.1080/1040841X.2016.1240656. Epub 2016 Dec 30.
Recent reports have demonstrated that most biofilms involved in catheter-associated urinary tract infections are polymicrobial communities, with pathogenic microorganisms (e.g. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and uncommon microorganisms (e.g. Delftia tsuruhatensis, Achromobacter xylosoxidans) frequently co-inhabiting the same urinary catheter. However, little is known about the interactions that occur between different microorganisms and how they impact biofilm formation and infection outcome. This lack of knowledge affects CAUTIs management as uncommon bacteria action can, for instance, influence the rate at which pathogens adhere and grow, as well as affect the overall biofilm resistance to antibiotics. Another relevant aspect is the understanding of factors that drive a single pathogenic bacterium to become prevalent in a polymicrobial community and subsequently cause infection. In this review, a general overview about the IMDs-associated biofilm infections is provided, with an emphasis on the pathophysiology and the microbiome composition of CAUTIs. Based on the available literature, it is clear that more research about the microbiome interaction, mechanisms of biofilm formation and of antimicrobial tolerance of the polymicrobial consortium are required to better understand and treat these infections.
最近的报告表明，大多数与导管相关的尿路感染中的生物膜是多微生物群落，致病微生物（如大肠杆菌、铜绿假单胞菌、肺炎克雷伯菌）和不常见微生物（如鹤见德尔夫特菌、木糖氧化无色杆菌）经常共同栖息在同一根导尿管中。然而，对于不同微生物之间发生的相互作用以及它们如何影响生物膜形成和感染结果，人们知之甚少。这种知识的缺乏影响了导管相关尿路感染的管理，因为例如不常见细菌的作用可以影响病原体粘附和生长的速度，以及影响生物膜对抗生素的总体抗性。另一个相关方面是了解促使单一病原菌在多微生物群落中占优势并随后引起感染的因素。在这篇综述中，提供了关于与侵袭性微生物感染相关的生物膜感染的概述，重点是导管相关尿路感染的病理生理学和微生物组组成。根据现有文献，显然需要对微生物组相互作用、生物膜形成机制和多微生物联合体的抗菌耐受性进行更多研究，以更好地理解和治疗这些感染。
