Invasion and diversity in Pseudomonas aeruginosa urinary tract infections.



Fothergill, Joanne ORCID: 0000-0002-7012-1508, Floyd, Rachel and Newman, John
(2022) Invasion and diversity in Pseudomonas aeruginosa urinary tract infections. Journal of Medical Microbiology, 71 (3). 001458-.

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Abstract

<b>Introduction.</b> <i>P. aeruginosa</i> is an opportunistic Gram-negative pathogen frequently isolated in urinary tract infections (UTI) affecting elderly and catheterized patients and associated with ineffective antibiotic treatment and poor clinical outcomes.<b>Gap statement.</b> Invasion has been shown to play an important role in UTI caused by <i>E. coli</i> but has only recently been studied with <i>P. aeruginosa</i>. The ability of <i>P. aeruginosa</i> to adapt and evolve in chronic lung infections is associated with resistance to antibiotics but has rarely been studied in <i>P. aeruginosa</i> UTI populations.<b>Aim.</b> We sought to determine whether phenotypic and genotypic heterogeneity exists in <i>P. aeruginosa</i> UTI isolates and whether, like urinary pathogenic <i>Escherichia coli</i>, these could invade human bladder epithelial cells - two factors that could complicate antibiotic treatment.<b>Methodology.</b> <i>P. aeruginosa</i> UTI samples were obtained from five elderly patients at the Royal Liverpool University Hospital as part of routine diagnostics. Fourty isolates from each patient sample were screened for a range of phenotypes. The most phenotypically diverse isolates were genome sequenced. Gentamicin protection assays and confocal microscopy were used to determine capacity to invade bladder epithelial cells.<b>Results.</b> Despite significant within-patient phenotypic differences, no UTI patient was colonized by distinct strains of <i>P. aeruginosa</i>. Limited genotypic differences were identified in the form of non-synonymous SNPs. Gentamicin protection assays and confocal microscopy provided evidence of <i>P. aeruginosa</i>'s ability to invade bladder epithelial cells.<b>Conclusions.</b> Phenotypic variation and cell invasion could further complicate antibiotic treatment in some patients. More work is needed to better understand <i>P. aeruginosa</i> UTI pathogenesis and develop more effective treatment strategies.

Item Type: Article
Uncontrolled Keywords: Urinary tract infection, antibiotic resistance, invasion, heterogeneity, intracellular
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology > School of Life Sciences
Depositing User: Symplectic Admin
Date Deposited: 02 Nov 2021 11:43
Last Modified: 15 Mar 2024 01:34
DOI: 10.1099/jmm.0.001458
Open Access URL: https://doi.org/10.1099/jmm.0.001458
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3142494