Abstract
BackgroundUrinary tract infections (UTIs) are one of the most common infections found in humans, with uropathogenic Escherichia coli (UPEC) being the most common cause. Prevention of UTI is a major global concern due to its recurrent nature, medical cost, and most importantly, the increased antimicrobial resistance among UPEC. The resistance in UPEC is mainly due to the Extended-Spectrum β-lactamases (ESBL), particularly the E. coli CTXM-15 type which is known for its rapid dissemination worldwide. Treatment options for E. coli CTXM-15 have become limited over recent years because of their multi-drug resistance, hence anti-virulent strategies based on herbal remedies, have considered as a viable option. The cranberry product, Cysticlean® capsules, contain 240 mg of proanthocyanins (PACs), which have been shown to significantly inhibit E. coli adherence, both in vitro and ex vivo, to uroepithelial cells.MethodIn this study, the cephalosporin-resistant E. coli isolate NCTC 1553 (E. coli CTXM-15) was analysed by qRT-PCR (quantitative Reverse Transcriptase -Polymerase Chain Reaction) for the expression of virulence factors after treatment with Cysticlean®. qRT-PCR was carried out to detect virulence determinants encoding for toxins SAT, and USP, the iron acquisition system ChuA, the protectins SoxS, KPSM, TraT and RecA, the antibiotic resistance gene CTX-M (encode β-lactamases), and the transporters IdfB and HcaT.ResultsCysticlean® significantly reduced the expression of all ten selected genes encoding for virulence factors and β-lactamases.ConclusionCranberry product Cysticlean® could represent a practicable alternative option for the prevention of recurrent UTI caused by multi-drug resistant E. coli CTXM-15, as the product acts on multiple bacterial targets.
Highlights
Urinary tract infections (UTIs) are among the most common infectious disease affecting humans and have been estimated to occur in at least 50% of women at some stage during their lives
RT-qPCR In this study, RT-qPCR was used to evaluate the impact of exposure of E. coli NCTC 13353 cells to the commercial cranberry product Cysticlean® on the expression of ten genes that have been shown to be associated with the virulence of uropathogenic Escherichia coli (UPEC)
Reports have shown that numerous genes are implicated in the virulence and fitness of UPEC, downregulating the expression of these genes could add to the efficiency of antibiotic treatment and could reduce the likelihood of treatment failure [17]
Summary
Urinary tract infections (UTIs) are among the most common infectious disease affecting humans and have been estimated to occur in at least 50% of women at some stage during their lives They are responsible for more than 7 million visits to physicians annually and 15% of all prescribed antibiotics in the US and European countries [1]. CTX-M-producing UPEC exhibits coresistance to other large antimicrobial families such as aminoglycosides and fluoroquinolones [9] This increasing level of UPEC multi-drug resistance is a great health and economic concern as it limits the therapeutic options available for the treatment of common bacterial infections such as UTIs. Urinary tract infections (UTIs) are one of the most common infections found in humans, with uropathogenic Escherichia coli (UPEC) being the most common cause. The cranberry product, Cysticlean® capsules, contain 240 mg of proanthocyanins (PACs), which have been shown to significantly inhibit E. coli adherence, both in vitro and ex vivo, to uroepithelial cells
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