尿路感染：微生物发病机制、宿主-病原体相互作用和新的治疗策略。
Urinary tract infections: microbial pathogenesis, host-pathogen interactions and new treatment strategies.
机构信息
Department of Molecular Microbiology, Washington University School of Medicine, St Louis, MO, USA.
Center for Women's Infectious Disease Research, Washington University School of Medicine, St Louis, MO, USA.
出版信息
Nat Rev Microbiol. 2020 Apr;18(4):211-226. doi: 10.1038/s41579-020-0324-0. Epub 2020 Feb 18.
Abstract
Urinary tract infections (UTIs) are common, recurrent infections that can be mild to life-threatening. The continued emergence of antibiotic resistance, together with our increasing understanding of the detrimental effects conferred by broad-spectrum antibiotic use on the health of the beneficial microbiota of the host, has underscored the weaknesses in our current treatment paradigm for UTIs. In this Review, we discuss how recent microbiological, structural, genetic and immunological studies have expanded our understanding of host-pathogen interactions during UTI pathogenesis. These basic scientific findings have the potential to shift the strategy for UTI treatment away from broad-spectrum antibiotics targeting conserved aspects of bacterial replication towards pathogen-specific antibiotic-sparing therapeutics that target core determinants of bacterial virulence at the host-pathogen interface.
摘要
尿路感染（UTI）是一种常见的、反复发作的感染，其严重程度从轻症到危及生命不等。抗生素耐药性的持续出现，以及我们对广谱抗生素使用对宿主有益微生物群健康产生的有害影响的认识不断加深，突显了我们目前 UTI 治疗模式的弱点。在这篇综述中，我们讨论了最近的微生物学、结构、遗传和免疫学研究如何扩展了我们对 UTI 发病机制中宿主-病原体相互作用的理解。这些基础科学发现有可能将 UTI 治疗策略从针对细菌复制保守方面的广谱抗生素转向针对宿主-病原体界面细菌毒力核心决定因素的具有抗生素保留作用的病原体特异性治疗方法。
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