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Chapter 18 : Epidemiology and Virulence of

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Abstract:

Awareness of the role of as an important opportunistic pathogen of the urinary tract in compromised individuals and hospitalized patients has increased over the last decades. The emergence of these bacteria exhibiting multiple antibiotic resistance phenotypes has made the treatment and management of urinary-tract infections (UTIs) difficult ( ). Although not frequently encountered as a cause of community-associated UTIs, is a leading cause of enterobacterial nosocomially acquired UTIs and is frequently prevalent as an infectious agent of patients with indwelling urinary catheters ( ). These catheter-associated urinary-tract infections (CAUTIs) can be source of invading organisms into the blood-stream among these compromised individuals, leading to serious infections with high morbidity and mortality rates. In addition, the frequency of UTIs in individuals residing in long-term-care facilities is increasing ( ). Therefore, the epidemiology of UTIs and CAUTIs indicates that factors that result in a decrease in the efficiency of the host immune system, for example, the insertion of an indwelling device such as a catheter, represents a significant increase in susceptibility to infection by these bacteria ( Table 1 ).

Citation: Clegg S, Murphy C. 2017. Epidemiology and Virulence of , p 435-457. 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-0005-2012
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Figure 1

Organization of the , , and fimbrial gene clusters in . The direction of transcription is indicated by the arrows and functions of the gene products are as follows:  , Structural subunit;  , regulatory proteins that directly or indirectly affect the expression of the gene encoding the major subunit;  , adhesin;  , periplasmic chaperone;  , outer membrane-scaffolding (usher) protein.

Citation: Clegg S, Murphy C. 2017. Epidemiology and Virulence of , p 435-457. 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-0005-2012
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Tables

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TABLE 1

Incidence of UTIs caused by

Citation: Clegg S, Murphy C. 2017. Epidemiology and Virulence of , p 435-457. 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-0005-2012
Generic image for table
TABLE 2

Risk factors associated with UTI

Citation: Clegg S, Murphy C. 2017. Epidemiology and Virulence of , p 435-457. 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-0005-2012
Generic image for table
TABLE 3

Summary of virulence factors involved in pathogenesis

Citation: Clegg S, Murphy C. 2017. Epidemiology and Virulence of , p 435-457. 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-0005-2012

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