Chapter 13 : Uropathogenic -Associated Exotoxins

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From as long ago as 1929, a study by MW Lyon indicated that the strains isolated from the urine of infected, symptomatic individuals were different than the fecal isolates from healthy individuals ( ). The urine isolates, when grown on blood agar plate medium, are commonly lytic to erythrocytes, whereas the fecal isolates are infrequently hemolytic. This was the first suggestion that the involved in extraintestinal diseases (ExPEC) are phenotypically different than the commensal strains common to the gastrointestinal tract. We now appreciate that the presence of no single virulence gene, including those encoding toxins, is the of ExPEC disease potential. This fact puts these in a much different context for disease potential than other classic human pathogens, such as , , and , where specific toxin genes essentially define these bacteria as pathogens. I bring this issue up in the introduction to this chapter to make the point that, among the variety of toxins that uropathogenic (UPEC) and more broadly, ExPEC possess, there are no examples of “must-have” toxin genes. Why this is the case I will leave for the reader to ponder while reading this review. In my conclusion, I will provide some opinions about the matter. What will now follow are summaries of the research on several families of protein toxins associated with the pathogenesis of that cause urinary-tract infections. This will include the repeats-in-toxin (RTX) family, cytotoxic-necrotizing factor (CNF), and the auto-transporter (AT) family/type V-secretion family.

Citation: Welch R. 2017. Uropathogenic -Associated Exotoxins, p 263-276. 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-0011-2012
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38. Månsson LE,, Kjäll P,, Pellett S,, Nagy G,, Welch RA,, Bäckhed F,, Frisan T,, Richter-Dahlfors A . 2007. Role of the lipopolysaccharide-CD14 complex for the activity of hemolysin from uropathogenic Escherichia coli . Infect Immun 75 : 997 1004.[PubMed] [CrossRef]
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Prominent protein toxins of uropathogenic

Citation: Welch R. 2017. Uropathogenic -Associated Exotoxins, p 263-276. 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-0011-2012

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