Urinary tract infections: microbial pathogenesis, host-pathogen interactions and new treatment strategies.

Urinary tract infections: microbial pathogenesis, host-pathogen interactions and new treatment strategies.
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DOI:
10.1038/s41579-020-0324-0
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发表时间:
2020-04
期刊:
Nature reviews. Microbiology
影响因子:
--
通讯作者:
Hultgren SJ
Hultgren SJ
中科院分区:
其他
文献类型:
--
作者:
Klein RD;Hultgren SJ

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尿路感染(uti)是常见的复发性感染,可以轻微到危及生命。抗生素耐药性的持续出现,以及我们对广谱抗生素使用对宿主有益微生物群健康的有害影响的日益了解,突显了我们目前对尿路感染治疗模式的弱点。在这篇综述中,我们讨论了最近的微生物学、结构学、遗传学和免疫学研究如何扩大了我们对尿路发病过程中宿主-病原体相互作用的理解。这些基本的科学发现有可能将UTI治疗策略从针对细菌复制保守方面的广谱抗生素转向针对宿主-病原体界面上细菌毒力核心决定因素的病原体特异性抗生素节省治疗。在这篇综述中,Klein和Hultgren讨论了我们对尿路感染中病原体和宿主相互作用的理解的最新进展,以及对宿主-病原体相互作用和发病机制的了解如何指导节省抗生素治疗的发展。
Urinary tract infections (UTIs) are common, recurrent infections that can be mild to life-threatening. The continued emergence of antibiotic resistance, together with our increasing understanding of the detrimental effects conferred by broad-spectrum antibiotic use on the health of the beneficial microbiota of the host, has underscored the weaknesses in our current treatment paradigm for UTIs. In this Review, we discuss how recent microbiological, structural, genetic and immunological studies have expanded our understanding of host-pathogen interactions during urinary tract pathogenesis. These basic scientific findings have the potential to shift the strategy for UTI treatment away from broad-spectrum antibiotics targeting conserved aspects of bacterial replication towards pathogen-specific antibiotic-sparing therapeutics that target core determinants of bacterial virulence at the host-pathogen interface. In this Review, Klein and Hultgren discuss recent advances in our understanding of the interplay between pathogens and host during urinary tract infections, and how the insights into host-pathogen interactions and pathogenesis are guiding the development of antibiotic-sparing therapeutics.
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