Abstract

Urinary tract infections are often polymicrobial and are mainly due to uropathogenic Escherichia coli (UPEC). We previously demonstrated a link among clinical fluoroquinolone susceptible E. coli reducing in vitro urothelial interleukin-8 (CXCL8) induced by E. coli K-12, polymicrobial cystitis, and pyuria absence. Here, we evaluated whether fifteen clinical fluoroquinolone susceptible UPEC were able to reduce CXCL8 induced by Enterococcus faecalis that had been isolated from the same mixed urines, other than CXCL8 induced by E. coli K-12. We also evaluated the connection between fluoroquinolone susceptibility and pathogenicity by evaluating the immune modulation of isogenic gyrA, a mutant UPEC resistant to ciprofloxacin. Using the 5637 bladder epithelial cell line, we observed that lower CXCL8 induced the most UPEC isolates than K-12 and the corresponding E. faecalis. During coinfections of UPEC/K-12 and UPEC/E. faecalis, we observed lower CXCL8 than during infections caused by K-12 and E. faecalis alone. UPEC strains showed host–pathogen and pathogen–pathogen interaction, which in part explained their persistence in the human urinary tract and coinfections, respectively. Mutant UPEC showed lower modulating activity with respect to the wildtypes, confirming the connection between acquired fluoroquinolone resistance and the decrease of innate microbial properties.

Highlights

  • Urinary tract infections (UTIs), the most common bacterial infections in humans, are mainly caused by uropathogenic Escherichia coli (UPEC) in both inpatients and outpatients and are often polymicrobial [1,2]

  • CXCL8 production of epithelial cells infected with each UPEC strain with that of cells infected with K-12

  • After observing that clinical UPEC had a lower stimulatory effect than the nonpathogenic E. coli K-12, we evaluated whether the same strains were able to modify the cellular response to K-12 during coinfections

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Summary

Introduction

Urinary tract infections (UTIs), the most common bacterial infections in humans, are mainly caused by uropathogenic Escherichia coli (UPEC) in both inpatients and outpatients and are often polymicrobial [1,2]. Mixed infections are recognized as significant burdens for human health and are of interest for the study of overall microbial pathogenicity and for bacteria in particular [3]. The most common group of microorganisms reported in co-infections is that of bacteria, which, differ from those causing the highest global mortality [4]. Even opposing ones, can favour or prevent the onset of co-infections and can be moments and modes for neutral, synergistic, or competitive interactions between different microorganisms. These different interactions mainly depend on the type of microorganism involved, the different characteristics of the specific strains, and the stages of infection [3,5].

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