Uropathogens and urinary tract concretion formation and catheter encrustations

Hedelin, Hans

doi:10.1016/s0924-8579(02)00095-x

Cited by 41 publications

(37 citation statements)

References 25 publications

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“…It is, however, an emerging cause of complicated UTIs, including infected kidney stones (11,(47)(48)(49) and CAUTIs (4,8,9,12,21). Here we resolve this paradox by demonstrating that MRSA exploits the presence of Fg that is released as part of an inflammatory response induced by the presence of a foreign body.…”

Section: Discussionmentioning

confidence: 85%

Catheterization alters bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract

Walker

Flores-Mireles

Pinkner

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

103

164

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Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of catheter-associated urinary tract infection (CAUTI), which frequently progresses to more serious invasive infections. We adapted a mouse model of CAUTI to investigate how catheterization increases an individual's susceptibility to MRSA UTI. This analysis revealed that catheterization was required for MRSA to achieve high-level, persistent infection in the bladder. As shown previously, catheter placement induced an inflammatory response resulting in the release of the host protein fibrinogen (Fg), which coated the bladder and implant. Following infection, we showed that MRSA attached to the urothelium and implant in patterns that colocalized with deposited Fg. Furthermore, MRSA exacerbated the host inflammatory response to stimulate the additional release and accumulation of Fg in the urinary tract, which facilitated MRSA colonization. Consistent with this model, analysis of catheters from patients with S. aureus-positive cultures revealed colocalization of Fg, which was deposited on the catheter, with S. aureus. Clumping Factors A and B (ClfA and ClfB) have been shown to contribute to MRSA-Fg interactions in other models of disease. We found that mutants in clfA had significantly greater Fg-binding defects than mutants in clfB in several in vitro assays. Paradoxically, only the ClfB − strain was significantly attenuated in the CAUTI model. Together, these data suggest that catheterization alters the urinary tract environment to promote MRSA CAUTI pathogenesis by inducing the release of Fg, which the pathogen enhances to persist in the urinary tract despite the host's robust immune response.host-pathogen interactions | MRSA CAUTI | ClfB-fibrinogen interactions

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Section: Discussionmentioning

confidence: 85%

Catheterization alters bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract

Walker

Flores-Mireles

Pinkner

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

103

164

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“…Within the stones bacteria are protected among crystals and the bacterial extracellular matrix. Antibiotics are less effective, emphasizing the importance of complete stone clearance to eradicate the infection and prevent stone recurrence [8] .…”

Section: Pathogenesismentioning

confidence: 99%

“…Citrate functions as an inhibiting factor for crystallization by forming complexes with calcium and magnesium, and its capacity to increase urinary pH is well known [8] . A normal urinary citrate concentration results in delayed nucleation and markedly reduced crystal aggregation [11,12] .…”

Section: Pathogenesismentioning

confidence: 99%

Stones and Urinary Tract Infections

Miano¹,

Germani²,

Vespasiani³

2007

Urol Int

116

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The term infection stones refers to calculi that occur following urinary tract infections (UTIs) caused by urease-producing gram-negative organisms. They consist of magnesium ammonium phosphate, carbonate apatite and monoammonium urate. Alkaline urine is most favorable to their formation. Urinary tract obstruction, neurogenic bladder, voiding dysfunction, temporary or indwelling urinary catheters, distal renal tubular acidosis and medullary sponge kidney are considered the main risk factors for developing infection stones. Urinalysis and urine culture are essential for diagnosis. A typical finding on imaging is a moderately radiopaque, staghorn or branched stone. Curative treatment is possible only by eliminating all of the stone fragments and by eradicating UTI. A variety of operative and pharmaceutical approaches is available. Metaphylactic treatment is mandatory to prevent recurrences. The relationship between urinary stones and UTIs is well known and shows two different clinical pictures: (1) stones that develop following UTIs (infection stones) which play a key role in stone pathogenesis, and (2) stones complicated by UTIs (stones with infection) which are metabolic stones that passively trap bacteria from coexistent UTIs and may consist of calcium or non-calcium. This article presents an overview of infection stones, analyzing the epidemiology, composition, pathogenesis, diagnosis, treatment and prevention of this type of calculi.

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“…Ammonium concentration (indophenol method; appendix), turbidity and pH were determined at the beginning of experiment and after (4,8) and (24) hours of incubation.…”

Section: Urea Agar Methodsmentioning

confidence: 99%

“…cloacae to form stone was investigated through testing the pH and crystal in human urine inoculated with E. cloacae, E. coli, and controlled urine without bacteria at (0, 4,8), and (24) hours of incubation. A gradual increase in the turbidity was noticed until the 4th hours when the rate of proliferation become faster, increasing the microbial population to the maximum when examined after an overnight incubation.…”

Section: Urease Production and Struvite Stone Formationmentioning

confidence: 99%