Abstract
Urinary tract infections (UTIs) are among the most common infections in most countries and they are usually caused by the so-called uropathogenic (UP) microorganisms, including Escherichia coli (80%–90%), Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, Proteus mirabilis, and Klebsiella pneumoniae. Over the years, the growth of resistance to antibiotics has complicated the treatment of UTIs and has direct consequences on the cost of treatment, the severity of infections, and the length of hospitalization. Medicinal plants, used for thousands of years to treat various diseases, constitute a serious alternative to antibiotics in the public health issue of antimicrobial resistance. In this review, the in vitro and in vivo use of medicinal plants and their nanoparticles (silver, gold, zinc, copper oxide, magnesium oxide, iron, etc.) in the management of uropathogens and their virulence factors (VFs) as well as in the management of UTIs themselves have been discussed. Given the advantages offered by the biologically active compounds of medicinal plants as well as their green-synthetized nanoparticles whether used as such or in combination with conventional antibiotics, it can be concluded that herbal medicine can significantly help in the management of UTIs.
Highlights
Urinary tract infections (UTIs) are very common infections in human population and can be defined as any infection, commonly of bacterial origin, which occurs in any part of the urinary system (Motse et al, 2019a)
In a study conducted in Hungary to assess the spectrum and antibiotic resistance of uropathogens between 2004 and 2015, Magyar et al (2017) found that the five most commonly occurring bacteria were E. coli, E. faecalis, K. pneumoniae, P. aeruginosa, and P. mirabilis; and in this period, the resistance of E. coli to ciprofloxacin increased significantly from 19% to 25 %, resistance rates of K. pneumoniae to cephalosporins were very high, and they observed a significant increase in the rate of carbapenem-resistant P. aeruginosa (Magyar et al, 2017)
In a study carried out by Alabsi et al (2014) to assess the association of some virulence genes with antibiotic resistance among uropathogenic Escherichia coli (UPEC) isolated from UTI patients in Alexandria (Egypt), it has been established that there is a significant association between the presence of the pap gene and resistance to gentamicin but it was not significantly associated with resistance to TMP/SMX, aminoglycosides, nitrofurantoin, quinolones, and β-lactam antibiotics
Summary
Urinary tract infections (UTIs) are very common infections in human population and can be defined as any infection, commonly of bacterial origin, which occurs in any part of the urinary system (Motse et al, 2019a). The resistance of UP strains is increasing, within some cases multidrug-resistant bacteria (MDR), and is not different from the global increase of the resistance to antibiotics observed around the world including all research areas (Dehbanipour et al, 2016; Karam et al, 2019; Kot, 2019; Lee et al, 2018; Mbarga et al, 2020, 2021; Motse et al, 2019b; Nzalie et al, 2016; Signing et al, 2020). Antibiotic resistance is a global issue that has led to a major mobilization in the search for new antimicrobial compounds and alternative ways of fighting bacterial infections. In this context, medicinal plants appear as a credible alternative (Wojnicz et al, 2012). The aim of this review is to discuss the plants commonly used to manage UTIs and particular importance is devoted to the mechanism of infections, host and risk factors in UTIs, uropathogens (UPs) themselves, their virulence factors (VFs), multidrug resistance issue, and a general view of the research carried out on the bacteriostatic and bactericidal properties of plant extracts on UPs
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