Urinary tract E. coli: the good guys versus the bad guys

在发达国家，大肠杆菌是尿路感染(UTI)的主要原因。仅在澳大利亚，每年就有超过25万人感染大肠杆菌，以至于需要医疗干预。据估计，1/4的女性和1/20的男性会在一生中患上尿路感染，在美国，尿路感染每年造成16亿美元的医疗费用。尿路致病性大肠杆菌(UPEC)菌株很容易在留置导尿管上形成生物膜，最近的证据表明，它们也在膀胱中形成生物膜样聚集体。除抗生素外，目前没有其他治疗方法(通常由于耐药性而无效)。大肠杆菌也是最常见的无症状性菌尿(ABU)的原因。ABU发生在高达6%的健康个体中，并影响到老年人和糖尿病患者等高危群体。一般来说，大多数ABU患者不需要治疗，在许多情况下，定植的微生物实际上有助于防止被其他更致命的细菌感染。该项目的目的是比较UPEC和ABU大肠杆菌在毒力和生物膜生长方面的差异。该项目将产生与引起尿路感染的大肠杆菌相关的全面和明确的菌种库。了解这种微生物的生物膜生长可能会导致改进和/或新的治疗方法的发展。此外，如果我们要充分探索将这些细菌用作益生菌的可能性，以防止在特定的高危患者群体中受到其他病原体的感染，增加对ABU大肠杆菌的了解是至关重要的。

Escherichia coli is the primary cause of urinary tract infection (UTI) in the developed world. In Australia alone, E. coli affects more than 250,000 yearly to the extent where they require medical intervention. It is estimated that one in four women and one in twenty men will develop a UTI in their lifetime and in the USA UTIs result in $1.6 billion in medical expenses each year. Uropathogenic E. coli (UPEC) strains readily form biofilms on indwelling catheters and recent evidence suggests that they also form biofilm-like aggregates in the bladder. No treatment other than antibiotics (often inefficient due to resistance) is currently available. E. coli is also the most frequent cause of asymptomatic bacteriuria (ABU). ABU occurs in up to 6% of healthy individuals and affects high risk groups such as the elderly and diabetics. In general, most patients with ABU do not need treatment and in many cases the colonizing organism actually helps to prevent infection by other more virulent bacteria. The aim of this project is to compare UPEC and ABU E. coli for differences associated with virulence and biofilm growth. The project will generate a comprehensive and defined strain bank relative to E. coli that cause UTI. Understanding biofilm growth by this organism may lead to the development of improved and-or novel treatments. Furthermore, increased knowledge of ABU E. coli is essential if we are to fully explore the possibility of employing these organisms as probiotic agents to prevent infection by other pathogens in specific high risk patient groups.