title: Impact of polymicrobial biofilms in catheter-associated urinary tract infections.
abstract: Recent reports have demonstrated that most biofilms involved in catheter-associated urinary tract infections are polymicrobial communities, with pathogenic microorganisms (e.g. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and uncommon microorganisms (e.g. Delftia tsuruhatensis, Achromobacter xylosoxidans) frequently co-inhabiting the same urinary catheter. However, little is known about the interactions that occur between different microorganisms and how they impact biofilm formation and infection outcome. This lack of knowledge affects CAUTIs management as uncommon bacteria action can, for instance, influence the rate at which pathogens adhere and grow, as well as affect the overall biofilm resistance to antibiotics. Another relevant aspect is the understanding of factors that drive a single pathogenic bacterium to become prevalent in a polymicrobial community and subsequently cause infection. In this review, a general overview about the IMDs-associated biofilm infections is provided, with an emphasis on the pathophysiology and the microbiome composition of CAUTIs. Based on the available literature, it is clear that more research about the microbiome interaction, mechanisms of biofilm formation and of antimicrobial tolerance of the polymicrobial consortium are required to better understand and treat these infections.
authors.affiliation: a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal.
authors.forename: Andreia S
authors.initials: AS
authors.lastname: Azevedo
authors.affiliation: a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal.|b Institute for Biotechnology and Bioengineering (IBB), Centre of Biological Engineering, Universidade do Minho , Braga , Portugal.
authors.forename: Carina
authors.initials: C
authors.lastname: Almeida
authors.affiliation: a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal.
authors.forename: Luís F
authors.initials: LF
authors.lastname: Melo
authors.affiliation: a Department of Chemical Engineering, Faculty of Engineering , Laboratory for Process Engineering, Environment, and Energy and Biotechnology Engineering (LEPABE), University of Porto , Porto , Portugal.
authors.forename: Nuno F
authors.initials: NF
authors.lastname: Azevedo
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D018441:Biofilms / Q000254:growth & development*; D055499:Catheter-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects; D056265:Microbial Interactions / Q000502:physiology*; D064307:Microbiota / Q000502:physiology*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Catheter-associated urinary tract infections; microbial ecology; microbiome; pathogenic bacteria; uncommon bacteria