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Review
. 2023 Jan 4;13(1):148.
doi: 10.3390/life13010148.

Biofilm Lifestyle in Recurrent Urinary Tract Infections

Amr S Abu Lila  1   2   3 , Azza A H Rajab  4 , Marwa H Abdallah  1   2   3 , Syed Mohd Danish Rizvi  1   2 , Afrasim Moin  1   2 , El-Sayed Khafagy  5   6 , Shams Tabrez  7   8 , Wael A H Hegazy  4   9
Affiliations
Review

Biofilm Lifestyle in Recurrent Urinary Tract Infections

Amr S Abu Lila et al. Life (Basel). .

Abstract

Urinary tract infections (UTIs) represent one of the most common infections that are frequently encountered in health care facilities. One of the main mechanisms used by bacteria that allows them to survive hostile environments is biofilm formation. Biofilms are closed bacterial communities that offer protection and safe hiding, allowing bacteria to evade host defenses and hide from the reach of antibiotics. Inside biofilm communities, bacteria show an increased rate of horizontal gene transfer and exchange of resistance and virulence genes. Additionally, bacterial communication within the biofilm allows them to orchestrate the expression of virulence genes, which further cements the infestation and increases the invasiveness of the infection. These facts stress the necessity of continuously updating our information and understanding of the etiology, pathogenesis, and eradication methods of this growing public health concern. This review seeks to understand the role of biofilm formation in recurrent urinary tact infections by outlining the mechanisms underlying biofilm formation in different uropathogens, in addition to shedding light on some biofilm eradication strategies.

Keywords: anti-virulence agents; biofilm eradication; biofilm formation; catheter-associated urinary tract infections; recurrent urinary tract infections.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The most frequent uropathogens (adopted from Flores-Mireles, et al., 2015). UTIs are caused by a wide range of Gram-negative and Gram-positive bacterial pathogens as well as fungi. Uropathogenic E. coli (UPEC) is the most common causative agent for both uncomplicated (75%) and complicated (65%) UTIs. The most prevalent pathogens in uncomplicated UTIs, in order of prevalence, are Klebsiella pneumoniae (6%), Staphylococcus saprophyticus (6%), Enterococcus faecalis (5%), group B Streptococcus (3%), Proteus mirabilis (2%), Pseudomonas aeruginosa (1%), Staphylococcus aureus (1%), and Candida spp. (1%). For complicated UTIs, the most prevalent pathogens are Enterococcus spp. (11%), K. pneumoniae (8%), Candida spp. (7%), S. aureus (3%), P. mirabilis (2%), P. aeruginosa (2%) and group B Streptococcus (2%).
Figure 2
Figure 2
Schematic representation of the stages involved in biofilm formation.
Figure 3
Figure 3
Bacterial QS systems in Gram-negative (A) two-component signaling, or (B) LuxI/LuxR-type QS systems. Gram-positive (C) two-component signaling, or (D) AIP-binding transcription factor QS systems. AI: Autoinducers, AIP: Autoinducing peptides.
Figure 4
Figure 4
Horizontal gene transfer mechanisms in microbial biofilms.
See this image and copyright information in PMC

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