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E. coli catheter-associated urinary tract infections are associated with distinctive virulence and biofilm gene determinants
Zongsen Zou, … , Gautam Dantas, Jeffrey P. Henderson
Zongsen Zou, … , Gautam Dantas, Jeffrey P. Henderson
Published December 13, 2022
Citation Information: JCI Insight. 2023;8(2):e161461. https://doi.org/10.1172/jci.insight.161461.
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Research Article Infectious disease Microbiology

E. coli catheter-associated urinary tract infections are associated with distinctive virulence and biofilm gene determinants

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Abstract

Urinary catheterization facilitates urinary tract colonization by E. coli and increases infection risk. Here, we aimed to identify strain-specific characteristics associated with the transition from colonization to infection in catheterized patients. In a single-site study population, we compared E. coli isolates from patients with catheter-associated asymptomatic bacteriuria (CAASB) to those with catheter-associated urinary tract infection (CAUTI). CAUTI isolates were dominated by a phylotype B2 subclade containing the multidrug-resistant ST131 lineage relative to CAASB isolates, which were phylogenetically more diverse. A distinctive combination of virulence-associated genes was present in the CAUTI-associated B2 subclade. Catheter-associated biofilm formation was widespread among isolates and did not distinguish CAUTI from CAASB strains. Preincubation with CAASB strains could inhibit catheter colonization by multiple ST131 CAUTI isolates. Comparative genomic analysis identified a group of variable genes associated with high catheter biofilm formation present in both CAUTI and CAASB strains. Among these, ferric citrate transport (Fec) system genes were experimentally associated with enhanced catheter biofilm formation using reporter and fecA deletion strains. These results are consistent with a variable role for catheter biofilm formation in promoting CAUTI by ST131-like strains or resisting CAUTI by lower-risk strains that engage in niche exclusion.

Authors

Zongsen Zou, Robert F. Potter, William H. McCoy 4th, John A. Wildenthal, George L. Katumba, Peter J. Mucha, Gautam Dantas, Jeffrey P. Henderson

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Figure 3

Biofilm formation by CAUTI, CAASB, and rectal isolates.

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Biofilm formation by CAUTI, CAASB, and rectal isolates.
(A) Transmission...
(A) Transmission electron microscopy (TEM) image of catheter biofilm grown in human urine. Scale bar: 4 μm. (B) TEM image of catheter biofilm grown in artificial urine medium (AUM). Scale bar: 4 μm. (C) Comparison of biofilm biomass (crystal violet retention) between B2 and non-B2 isolates. Mean ± SD plotted for 28 B2 and 13 non-B2 strains. P = 0.22. (D) Comparison of catheter-adherent CFUs between B2 and non-B2 isolates. Mean ± SD plotted for 28 B2 and 13 non-B2 strains. P = 0.02. (E) Comparison of planktonic CFUs in the voided media between B2 and non-B2 isolates. Mean ± SD plotted for 28 B2 and 13 non-B2 strains. P = 0.57. (F) Comparison of biofilm biomass (crystal violet retention) between B2a and B2b isolates. Mean ± SD plotted for 15 B2a and 13 B2b strains. P = 0.62. (G) Comparison of catheter-adherent CFUs between B2a and B2b isolates. Mean ± SD plotted for 15 B2a and 13 B2b strains. P = 0.73. (H) Comparison of planktonic CFUs in the voided media between B2a and B2b isolates. Mean ± SD plotted for 15 B2a and 13 B2b strains. P = 0.13. Statistics were performed with Mann-Whitney U test with P ≤ 0.05 considered as statistically significant. *P ≤ 0.05.

Copyright © 2023 American Society for Clinical Investigation
ISSN 2379-3708

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