Abstract

The Gram negative rods as Escherichia coli and Klebsiella pneumoniae belong to the most common etiology agents of urinary tract infections. The aim of our study was to assess the diversity of biofilm formed in different urinary tract diseases and their impact on monocytes’ adherence and activation. The bacteria were obtained from patients with different kidney problems. Some of the patients were after renal transplantation, some of them were not. Changes in the size and granularity of monocytes, as well as their adherence to biofilm, were assessed using FACSVerse flow cytometer after 1 h co-incubation of monocytes and bacterial biofilm in 37 °C. The obtained results were validated against monocytes incubated without bacteria. The isolates from patients with chronic kidney disease formed the most adherent biofilm regardless the presence or absence of inflammatory reaction. Adherence of monocytes also increased during therapy with immunosuppressive agents, but monocytes’ response was different when cyclosporine or tacrolimus were used. Additionally the presence of inflammatory reaction in patients with kidney disease modified the monocytes response when the immunosuppressive drugs were used. Considering the obtained results, we conclude that the changes of monocytes’ morphology in response to biofilm formed by Gram negative rods could become a tool to detect urinary tract infection, especially in those groups of patients, where the knowledge of ongoing inflammation is important and the standard tools fail to detect it.

Highlights

  • The dispute on differences between commensals found accidentally in urine and pathogens of urinary tract seems to be far from complete

  • The fact that specific comorbidities seem to affect the selection of strains causing recurrent urinary tract infections (UTIs) (RUTI) is the reason, why we aimed to evaluate the influence of other clinical parameters of the host on the biofilm properties of urine isolates of E. coli and K. pneumoniae

  • All used estimators (FSC, SSC and monocytes’ adherence to biofilm) are clearly modified by the type of kidney disease and profile of immunosuppression used in RTx patients as showed on Fig. 1

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Summary

Introduction

The dispute on differences between commensals found accidentally in urine and pathogens of urinary tract seems to be far from complete. Urinary tract infection (UTI) is a serious health problem for several reasons, e.g. increasing problem with antibiotic resistance, possible renal scarring and sepsis development as a complication (Khan et al 2019; Sabih and Leslie 2020). The most common etiology agents of UTIs are Gram negative rods of Enterobacteriaceae family, including Escherichia coli and Klebsiella pneumoniae. Because of the common antibiotic resistance of K. pneumoniae, infections caused by this pathogen are raising concern (Gołębiewska et al 2019). K. pneumoniae may cause both, communityacquired and hospital-acquired infections. Isolates from hospital-acquired infections usually lack virulence genes but are resistant to many antibiotics. K. pneumoniae has been shown to be the most common pathogen in recurrent UTIs during the first year after renal transplantation (Gołębiewska et al 2019)

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