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Chapter 12 : Virulence and Fitness Determinants of Uropathogenic

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Abstract:

Urinary tract infections (UTIs) are one of the most common bacterial infections affecting humans, and uropathogenic (UPEC) is the etiological agent in 75% to 95% of UTIs in otherwise healthy individuals ( ). Based on the presence or absence of anatomic abnormalities and recent history of instrumentation in the urinary tract, UTIs are divided into either complicated or uncomplicated cases, respectively. UPEC is the most common cause of uncomplicated UTIs in humans. In clinical settings, UTIs are described with specific reference to the site of inflammation; cystitis indicates inflammation of the urinary bladder and pyelonephritis indicates inflammation of the renal pelvis and the kidneys. Presence of bacteria (bacteriuria) and neutrophils in the urine are hallmarks of UTIs caused by UPEC. Some patients, however, are bacteriuric unaccompanied with symptoms of UTI for long periods. This condition is referred to as asymptomatic bacteriuria (ABU) and is the most benign form of colonization in the human urinary tract. In patients suffering from pyelonephritis, UPEC can gain access to renal capillaries, leading to bacteremia (presence of bacteria in blood) and sepsis with the latter being the most dangerous and potentially fatal complication of UTIs caused by UPEC. Numerous virulence and fitness factors confer advantages to UPEC within host urinary tract and are discussed in this chapter.

Citation: Subashchandrabose S, Mobley H. 2017. Virulence and Fitness Determinants of Uropathogenic , p 235-261. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0015-2012
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Figure 1

A simple model of iron uptake in UPEC. UPEC produces iron-scavenging molecules known as siderophores. Cognate outer-membrane receptors bind ferri-siderophore complexes or heme that are then imported into the periplasm. Within the periplasm, they associate with periplasmic-binding proteins. Translocation across the inner membrane involves ABC transporters. Iron is extracted from iron-siderophore complexes and heme via multiple reactions, denoted by broken arrows. In the presence of iron, Fur represses (X) transcription of the genes involved in iron uptake. Iron limitation within the host urinary tract results in the derepression of Fur-regulated genes, including siderophore-biosynthetic genes. UPEC, uropathogenic ; OM, outer membrane; P, periplasm; IM, inner membrane; C, cytoplasm; Fur, ferric-uptake regulator; Fe, ferric iron; and TonB, ExbB, ExbD, energy-transduction complex for transport of iron-containing complexes to the periplasm.

Citation: Subashchandrabose S, Mobley H. 2017. Virulence and Fitness Determinants of Uropathogenic , p 235-261. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0015-2012
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Image of Figure 2
Figure 2

Metabolism in UPEC during infection. Amino acids and di/oligo peptides are the primary sources of carbon and nitrogen for the UPEC within urinary tract. Mutants defective in peptide transport exhibit a fitness defect . Pyruvate is generated from amino acids and feeds into the citric-acid cycle and gluconeogenesis. Disruption of either citric-acid cycle or gluconeogenesis is detrimental for the survival of UPEC within the urinary tract. UPEC, uropathogenic ; OM, outer membrane; P, periplasm; IM, inner membrane; and C, cytoplasm.

Citation: Subashchandrabose S, Mobley H. 2017. Virulence and Fitness Determinants of Uropathogenic , p 235-261. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0015-2012
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Figure 3

Regulation of flagellar motility in UPEC. , master regulator of the flagellar-biosynthesis cascade, is subject to both positive and negative regulation. Note that not all regulators affect the transcription of directly. Regulators such as PhoP and QseB are activated in response to specific cues encountered by UPEC. Various signals are integrated into the flagellar gene expression cascade via two-component regulatory systems and other signal-transduction cascades. UPEC, uropathogenic ; OM, outer membrane; P, periplasm; IM, inner membrane; and C, cytoplasm.

Citation: Subashchandrabose S, Mobley H. 2017. Virulence and Fitness Determinants of Uropathogenic , p 235-261. In Mulvey M, Klumpp D, Stapleton A (ed), Urinary Tract Infections: Molecular Pathogenesis and Clinical Management, Second Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.UTI-0015-2012
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