Abstract
Urinary tract infections (UTIs) are some of the most common infections in human medicine worldwide, recognized as an important public health concern to healthcare systems around the globe. In addition, urine specimens are one of the most frequently submitted samples for culture to the clinical microbiology laboratory, exceeding the number of most of the other sample types. The epidemiology, species-distribution and susceptibility-patterns of uropathogens vary greatly in a geographical and time-dependent manner and it also strongly correlated with the reported patient population studied. Nevertheless, many studies highlight the fact that the etiological agents in UTIs have changed considerably, both in nosocomial and community settings, with a shift towards “less common” microorganisms having more pronounced roles. There is increasing demand for further research to advance diagnostics and treatment options, and to improve care of the patients. The aim of this review paper was to summarize current developments in the global burden of UTI, the diagnostic aspects of these infectious pathologies, the possible etiological agents and their virulence determinants (with a special focus on the members of the Enterobacterales order), current guidelines and quality indicators in the therapy of UTIs and the emergence of multidrug resistance in urinary pathogens.
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- ACSS:
-
Acute Cystitis Symptom Score
- AP:
-
acute pyelonephritis
- ASB:
-
asymptomatic bacteriuria
- AUC:
-
acute uncomplicated cystitis
- CAUTI:
-
catheter-associated UTI
- CDC:
-
Centers for Disease Control
- CFU:
-
colony-forming units
- CRGNB:
-
carbapenem-resistant Gram-negative bacilli
- cUTI:
-
complicated UTI
- ECDC:
-
European Centre for Disease Prevention and Control
- ESBL:
-
extended-spectrum β-lactamase
- ExPEC:
-
extra-intestinal pathogenic Escherichia coli
- GNB:
-
Gram-negative bacteria
- ICE:
-
integrative and conjugative element
- IDSA:
-
Infectious Diseases Society of America
- InCOM:
-
intra-intestinal commensal
- InPEC:
-
intra-intestinal pathogenic Escherichia coli
- LPS:
-
lipopolysaccharide
- m/z:
-
mass-to-charge
- MALDI-TOF MS:
-
matrix-assisted laser desorption/ionization time-of-flight mass spectrometry
- MDR:
-
multidrug-resistant
- MRSA:
-
methicillin-resistant Staphylococcus aureus
- MRSA:
-
methicillin-resistant Staphylococcus epidermidis
- MRSE:
-
methicillin-resistant Staphylococcus epidermidis
- MSSA:
-
methicillin-sensitive Staphylococcus aureus
- NACA:
-
non-albicans Candida
- NECE:
-
non-E. coli Enterobacterales
- NGS:
-
next-generation sequencing
- NICE:
-
The National Institute for Health and Care Excellence
- OMP:
-
outer membrane proteins
- OMV:
-
outer membrane vesicles
- PAI:
-
pathogenicity islands
- PCR:
-
polymerase chain-reaction
- PDR:
-
pandrug-resistant
- PROM:
-
patient-reported outcome measures
- QI:
-
quality indicator
- QoL:
-
quality of life
- rRNA:
-
ribosomal RNA
- RTX:
-
repeats in toxin
- rUTI:
-
recurrent UTI
- ShiToPInPEC:
-
Shigella Toxin Producer InPEC
- TMP/SMX:
-
trimethoprim-sulfamethoxazole
- UPCA:
-
uropathogenic Candida albicans
- UPEC:
-
uropathogenic Escherichia coli
- US:
-
United States
- UTI:
-
urinary tract infections
- VF:
-
virulence factors
- VRE:
-
vankomycin-resistant Enterococcus
- WHO:
-
World Health Organization
- XDR:
-
extensively drug resistant
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. M.G. was supported by the National Youth Excellence Scholarship (Grant Number NTP-NTFÖ-18-C-0225) and ESCMID’s “30 under 30” Award.
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Behzadi, P., Urbán, E., Matuz, M., Benkő, R., Gajdács, M. (2020). The Role of Gram-Negative Bacteria in Urinary Tract Infections: Current Concepts and Therapeutic Options. In: Donelli, G. (eds) Advances in Microbiology, Infectious Diseases and Public Health. Advances in Experimental Medicine and Biology(), vol 1323. Springer, Cham. https://doi.org/10.1007/5584_2020_566
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