Bacterial filamentation during urinary tract infections

Abstract

Urinary tract infections (UTIs) are established when a uropathogenic microbe enters the urinary tract, avoids the immune system, and initiates colonization and infection that damages the host They are among the most common bacterial infections with many resulting in antimicrobial resistance (AMR)-related deaths A study over 10 years, following 700,000 community-acquired UTIs, found that uropathogenic Escherichia coli (UPEC) was the causative agent in 70% of cases, with Klebsiella pneumoniae and Proteus mirabilis in 10% and 5% of cases, respectively Estimations have suggested that at least 150 million people experience a UTI annually Certain groups are disproportionately at risk, with the majority (approximately 60%) of women experiencing at least one UTI in their lifetime Recurrent UTIs (rUTIs) are also prevalent: With up to 25% of patients experience another infection in months after apparently successful antimicrobial treatment, partly due to the rise of antibiotic-resistant UTI pathogens It is not yet clear how rUTIs are so persistent, but key to understanding this may be in the specific bacterial lifestyles and infection cycles, where bacterial filamentation and L-form formation have been suggested to play important roles While L-form formation may be an important reservoir for persistent UTIs, it is outside the scope of this text, as in this Pearls, we focus on what is known about bacterial filamentation and reversal in a bladder environment.

Topics & Concepts