Abstract
Urinary tract infections (UTIs) are one of the most common bacterial infections, affecting 150 million people each year worldwide. High recurrence rates and increasing antimicrobial resistance among uropathogens are making it imperative to develop alternative strategies for the treatment and prevention of this common infection. In this Review, we discuss how understanding the: (i) molecular and biophysical basis of host-pathogen interactions; (ii) consequences of the molecular cross-talk at the host pathogen interface in terms of disease progression; and (iii) pathophysiology of UTIs is leading to efforts to translate this knowledge into novel therapeutics to treat and prevent these infections.
Highlights
Urinary tract infections (UTIs) can be acquired in the community or hospital setting and are one of the most common bacterial infections that occur, affecting more than 150 million people worldwide each year [1,2,3]
Much of our understanding of UTI and recurrent infection (rUTI) pathogenesis comes from studies in mice
We discuss advances in our understanding of UTI pathogenesis based on experiments performed in relevant mouse models and highlight how these findings have been recapitulated in clinical studies performed in women with UTI or rUTI
Summary
Urinary tract infections (UTIs) can be acquired in the community or hospital setting and are one of the most common bacterial infections that occur, affecting more than 150 million people worldwide each year [1,2,3]. UTIs are categorized as uncomplicated or complicated infections. While many bacterial organisms cause UTI, the most common causative agent of both uncomplicated and complicated UTI is the gram-negative pathogen uropathogenic Escherichia coli (E. coli) (UPEC). The rise of single and multi-drug resistant uropathogens as well as high rates of recurrence in women infected with both antibiotic sensitive and drug-resistant uropathogens has become a major concern, highlighting the need to develop alternative strategies to treat patients with UTI and CAUTI. We will focus mainly on UTI and CAUTI caused by UPEC and Enterococcus spp. due to the high prevalence of these pathogens in community-acquired and nosocomial infections. We will explore the development of alternative, non-antibiotic treatment strategies that target adhesive pili in order to prevent UPEC and Enterococcus spp. from initiating infection and causing disease
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