title: Persistence of uropathogenic Escherichia Coli in the bladders of female patients with sterile urine after antibiotic therapies.
abstract: This study aimed to provide evidence of persistent uropathogenic Escherichia coli (UPEC) in female patients with recurrent urinary tract infection (UTI) after antibiotic therapy. We collected biopsies of the bladder, and clean-catch urine samples from 32 women who had episodes of recurrent UTI and were given antibiotic therapy. Urine samples and biopsies were analyzed by conventional bacteriological techniques. Phylogenetic group and 16 virulence factors (VFs) of UPEC were determined using polymerase chain reaction (PCR). The infection capability of UPEC was confirmed in a mouse model. Immunofluorescence and electron microscopy were used to detect intracellular bacterial communities (IBCs) in the mouse model. The results showed that all urine specimens were detected sterile. E. coli was found in 6 of 32 biopsies (18.75%), and was identified to be UPEC by PCR. Different VFs associated with the formation of IBCs were identified in all six UPEC isolates. Each UPEC isolate was capable of forming IBCs within the bladder epithelial cells of mice. In conclusion, UPEC with distinctive pathological traits and the capability of IBC formation was first found in the bladders of women after antibiotic therapy, suggesting that the IBC pathogenic pathway may occur in humans and it plays an important role in UTI recurrence.
authors.affiliation: Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Shu-Cheng
authors.initials: SC
authors.lastname: Liu
authors.affiliation: Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. lhangbm@163.com.
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Han
authors.affiliation: Department of Urology, Nanhai Hospital, Southern Medical University, Foshan, 528000, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Shi
authors.affiliation: Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
authors.forename: Zi-Li
authors.initials: ZL
authors.lastname: Pang
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001706:Biopsy; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D051379:Mice; D008875:Middle Aged; D010802:Phylogeny; D001743:Urinary Bladder / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D056689:Uropathogenic Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity
chemical_list: D000900:Anti-Bacterial Agents
keywords: intracellular bacterial communities; persistence; urinary tract infection; uropathogenic Escherichia coli