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尿路致病性大肠杆菌研究进展:深入了解其特征、耐药机制及治疗选择

Uropathogenic Escherichia coli endeavors: an insight into the characteristic features, resistance mechanism, and treatment choice.

作者信息

Arafi Vahid, Hasani Alka, Sadeghi Javid, Varshochi Mojtaba, Poortahmasebi Vahdat, Hasani Akbar, Hasani Roqaiyeh

机构信息

Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Arch Microbiol. 2023 May 8;205(6):226. doi: 10.1007/s00203-023-03553-5.

Abstract

Uropathogenic Escherichia coli (UPEC) are the strains diverted from the intestinal status and account mainly for uropathogenicity. This pathotype has gained specifications in structure and virulence to turn into a competent uropathogenic organism. Biofilm formation and antibiotic resistance play an important role in the organism's persistence in the urinary tract. Increased consumption of carbapenem prescribed for multidrug-resistant (MDR) and Extended-spectrum-beta lactamase (ESBL)-producing UPECs, has added to the expansion of resistance. The World Health Organization (WHO) and Centre for Disease Control (CDC) placed the Carbapenem-resistant Enterobacteriaceae (CRE) on their treatment priority lists. Understanding both patterns of pathogenicity, and multiple drug resistance may provide guidance for the rational use of anti-bacterial agents in the clinic. Developing an effective vaccine, adherence-inhibiting compounds, cranberry juice, and probiotics are non-antibiotical approaches proposed for the treatment of drug-resistant UTIs. We aimed to review the distinguishing characteristics, current therapeutic options and promising non-antibiotical approaches against ESBL-producing and CRE UPECs.

摘要

尿路致病性大肠杆菌(UPEC)是从肠道状态转变而来的菌株,主要导致尿路致病性。这种致病型在结构和毒力方面已具备特定特征,从而成为一种有能力致病的尿路病原体。生物膜形成和抗生素耐药性在该生物体于尿路中的持续存在中起着重要作用。用于治疗耐多药(MDR)和产超广谱β-内酰胺酶(ESBL)的UPEC而开具的碳青霉烯类药物的使用增加,加剧了耐药性的扩散。世界卫生组织(WHO)和疾病控制中心(CDC)已将耐碳青霉烯类肠杆菌科细菌(CRE)列入其治疗优先清单。了解致病性模式和多重耐药性可能为临床合理使用抗菌药物提供指导。开发有效的疫苗、粘附抑制化合物、蔓越莓汁和益生菌是针对耐药性尿路感染提出的非抗生素治疗方法。我们旨在综述产ESBL和CRE的UPEC的独特特征、当前的治疗选择以及有前景的非抗生素治疗方法。

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