Virulence Factors and Innovative Strategies for the Treatment and Control of Uropathogenic Escherichia coli

Abstract

Abstract Urinary tract infections (UTIs) are considered to be the most frequent bacterial infections. Escherichia coli is the major factor of community-acquired UTI (80–90%) and a large part of nosocomial UTI (30%), including cystitis, pyelonephritis, prostatitis, and asymptomatic bacteriuria. Uropathogenic E. coli (UPEC) shows a variety of virulence factors that allow their transition from the intestinal tract to the urinary tract and causing infection. The virulence factors responsible for pathogenesis outside the gastrointestinal tract belong to various functional groups. Antimicrobial resistance among E. coli causing UTIs is increas- ing in many countries around the world. This paper presents key virulence factors of UPEC such as adhesins, toxins, iron acquisition systems, and biofilm formation by UPEC, which are major problems in patients with long-term catheterization. The resistance of UPEC to antibiotics and innovative strategies of treatment and control of UPEC includ- ing drug therapy, preventive vaccines, probiotics, cranberry as source of antimicrobial metabolites, bacteriophages, new therapeutic antibiofilm treatment such as engineered phages, nanoparticles, and plant-derived antibacterial agents are also presented.