Urinary Tract Infections and Antibiotic Resistance

Dear Colleagues,

Urinary tract infections (UTIs) are among the most common bacterial infections in humans, accounting for high morbidity, prolonged hospitalization, and high medical costs. Uropathogenic Escherichia coli (UPEC) is responsible of the majority of community- and hospital-acquired UTIs. UPEC are able to invade urinary epithelial cells, where they may replicate and form biofilm-like intracellular bacterial communities (IBCs) protected from host defenses and antibiotic treatment. The occurrence of IBCs in the bladder appears to be associated with an increased risk of recurrent UTIs. Epidemiological characterization and knowledge of the most relevant components of UPEC array of pathogenicity factors together with the major host responses to infection are an evolving field of research. Recent advances in the analysis of microbial communities colonizing the human body have identified a resident microbial community in the human urinary tract. However, the contribution of UPEC pathobiology needs to be clarified. Further investigations into UPEC’s ability to cause infection and its interaction with the urobiome are required. UTIs are becoming increasingly difficult to treat owing to the rapid emergence and worldwide spread of antibiotic resistant UPEC. Future research should be devoted to careful monitoring of the antimicrobial use for UTI treatment. Knowledge of the UPEC drug resistance could help us to understand the pathogenesis of UTIs and direct towards better clinical treatments. Antibiotic resistance is frequently detected among commensal bacteria from animals, raising important questions on the potential impact of antibiotic use in the veterinary field and on a possible transmission of these resistant bacteria to humans, directly or via the food chain. It has been suggested that animals are the alternative reservoirs for UPEC strains that are associated with human UTIs. Genes encoding virulence factors and antibiotic resistance have been described in pathogenic E. coli isolates from animals. The characterization of these strains could be of great interest to develop policies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms. Shedding light on dynamic events occurring during UTIs could represent a great tool to identify new potential approaches to fight the infection. The development of new innovative strategies designed to fight these dangerous pathogens is highly needed.

Dr. Catia Longhi
Dr. Maria Grazia Ammendolia
Dr. Carlo Zagaglia
Guest Editors

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• host–pathogen interactions
• bacterial persistence
• urobiome
• antibiotic resistance
• E. coli strains from animal sources
• new treatment strategies