ORCID
- Upton, Mathew: 0000-0003-4287-6396
Abstract
BACKGROUND: Escherichia coli O25b:H4-ST131 represents a predominant clone of multidrug-resistant uropathogens currently circulating worldwide in hospitals and the community. Urinary tract infections (UTIs) caused by E. coli ST131 are typically associated with limited treatment options and are often recurrent. METHODS: Using established mouse models of acute and chronic UTI, we mapped the pathogenic trajectory of the reference E. coli ST131 UTI isolate, strain EC958. RESULTS: We demonstrated that E. coli EC958 can invade bladder epithelial cells and form intracellular bacterial communities early during acute UTI. Moreover, E. coli EC958 persisted in the bladder and established chronic UTI. Prophylactic antibiotic administration failed to prevent E. coli EC958-mediated UTI. However, 1 oral dose of a small-molecular-weight compound that inhibits FimH, the type 1 fimbriae adhesin, significantly reduced bacterial colonization of the bladder and prevented acute UTI. Treatment of chronically infected mice with the same FimH inhibitor lowered their bladder bacterial burden by >1000-fold. CONCLUSIONS: In this study, we provide novel insight into the pathogenic mechanisms used by the globally disseminated E. coli ST131 clone during acute and chronic UTI and establish the potential of FimH inhibitors as an alternative treatment against multidrug-resistant E. coli.
DOI
10.1093/infdis/jit245
Publication Date
2013-09-01
Publication Title
J Infect Dis
Volume
208
Issue
6
First Page
921
Last Page
928
Organisational Unit
School of Biomedical Sciences
Keywords
E. coli ST131, antibiotic resistance, biofilm, mannoside, type 1 fimbriae, urinary tract infection, uropathogenic E. coli, Acute Disease, Adhesins, Escherichia coli, Administration, Oral, Animals, Anti-Bacterial Agents, Chronic Disease, Cystitis, Disease Models, Animal, Dose-Response Relationship, Drug, Drug Resistance, Multiple, Bacterial, Female, Fimbriae Proteins, Fimbriae, Humans, Mice, Inbred C3H, Urinary Bladder, Uropathogenic Escherichia coli
Recommended Citation
Totsika, M., Kostakioti, M., Hannan, T., Upton, M., Beatson, S., Janetka, J., Hultgren, S., & Schembri, M. (2013) 'A FimH inhibitor prevents acute bladder infection and treats chronic cystitis caused by multidrug-resistant uropathogenic Escherichia coli ST131.', J Infect Dis, 208(6), pp. 921-928. Available at: https://doi.org/10.1093/infdis/jit245
