From the Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY.
Urogynecology (Phila). 2024 Mar 1;30(3):320-329. doi: 10.1097/SPV.0000000000001476.
The relationship between Enterococcus faecalis vaginal colonization and urinary tract infections (UTIs) remains uncertain.
We aimed to evaluate the surface invasion capability of E faecalis isolates from patients with and without UTIs as a potential readout of pathogenicity.
Participants were females from urogynecology clinics, comprising symptomatic UTI and asymptomatic non-UTI patients, categorized by the presence or absence of E faecalis-positive cultures identified via standard urine culture techniques. Vaginal and urine samples from patients were plated on enterococci selective medium, and E faecalis isolates detected in both cohorts were species specific identified using 16S rRNA sequencing. Clinical isolates were inoculated on semisolid media, and both external colonies and underneath colony prints formed by agar-penetrating enterococci were imaged. External growth and invasiveness were quantified by determining colony-forming units of the noninvading and agar-penetrating cells and compared with the E faecalis OG1RF.
We selected E faecalis isolates from urine and vaginal samples of 4 patients with and 4 patients without UTIs. Assays demonstrated that most isolates formed similarly sized external colonies with comparable colony-forming unit. Surface invasion differed across patients and isolation sites compared with OG1RF. The vaginal isolate from UTI patient 1, who had the most recurrences, exhibited significantly greater agar-invading capacity compared with OG1RF.
Our pilot study indicates that ex vivo invasion assays may unveil virulence traits in E faecalis from UTI patients. Enhanced enterococcal surface penetration could increase urogenital invasion risk. Further research is needed to correlate penetration with disease severity in a larger patient group.
肠球菌属粪肠球菌阴道定植与尿路感染（UTIs）之间的关系仍不确定。
我们旨在评估来自有和无 UTIs 患者的粪肠球菌分离株的表面侵袭能力，作为潜在致病性的指标。
参与者为来自泌尿科妇科诊所的女性，包括有症状的 UTI 和无症状的非 UTI 患者，通过标准尿液培养技术确定的粪肠球菌阳性培养物的存在或不存在进行分类。从患者中采集阴道和尿液样本，接种于肠球菌选择性培养基上，在两个队列中均检测到的粪肠球菌分离株采用 16S rRNA 测序进行种特异性鉴定。将临床分离株接种于半固体培养基上，并对琼脂穿透肠球菌形成的外部菌落和菌落印下进行成像。通过确定非侵入性和琼脂穿透细胞的集落形成单位来量化外部生长和侵袭性，并与 OG1RF 进行比较。
我们从 4 名有 UTIs 和 4 名无 UTIs 的患者的尿液和阴道样本中选择了粪肠球菌分离株。实验表明，大多数分离株形成了具有相似大小的外部菌落，且集落形成单位相似。与 OG1RF 相比，患者和分离部位的表面侵袭性存在差异。来自 UTI 患者 1 的阴道分离株，复发次数最多，与 OG1RF 相比，其琼脂穿透能力显著增强。
我们的初步研究表明，体外侵袭试验可能揭示 UTI 患者粪肠球菌的毒力特征。增强的肠球菌表面穿透能力可能会增加泌尿生殖道侵袭的风险。需要进一步的研究来在更大的患者群体中，将穿透性与疾病严重程度相关联。
