Enterobacteria responsible for urinary infections: a review about pathogenicity, virulence factors and epidemiology

ABSTRACT

Urinary tract infections (UTIs) are one of the most common types of bacterial infections in humans, bothin the community and in health care settings. UTIs include a range of clinical entities ranging in severityfrom asymptomatic infection to acute cystitis, prostatitis, pyelonephritis, and urethritis. This is one of themost common diseases encountered in medical practice today, affecting people of all ages, from newborn togeriatric age group. The bacteria most commonly implicated as agents responsible for UTIs generally originatein the intestine and include Escherichia coli, Pseudomonas spp., Streptococcus spp., Proteus spp., Klebsiellaspp., Staphylococcus spp., Neisseria gonorrhoeae, Chlamydia trachomatis, and Candida spp. There arevirulence factors of urinary pathogens that promote adhesion to mucosal surfaces and subsequent infections.The multiresistant of these enterobacteria responsible for UTIs is a major public health problem. Antibioticresistance remains a major problem, especially in the developing countries where hygiene conditions are stillprecarious and antibiotic use is often abusive and poorly controlled. The multidrug-resistant Enterobacteriaceaemost implicated in UTIs by extended-spectrum beta-lactamases (ESBL) and carbapenemase production areKlebsiella pneumoniae, E. coli, and Proteus spp., not to mention Acinetobacter baumanii and Pseudomonasaeruginosa, the most carbapenemase producing. The detection of ESBL and carbapenemase production isbased mainly on phenotypic and genotypic tests.