Uropathogenic Escherichia coli in urinary tract infections: A review on epidemiology, pathogenesis, clinical manifestation, diagnosis, treatments and prevention

Abstract

Urinary tract infections (UTIs) are common pathological conditions observed in hospital settings and communities. Uropathogenic Escherichia coli (UPEC) is the causative agent of most of the UTIs, such as pyelonephritis and cystitis. The infectious complications may cause acute renal failure affecting both the healthy and renal transplant patient's. The untreated patients with UTI may exhibit septicemia and bacteremia. Furthermore, the multidrug resistance patterns of UPEC may result in severe septic shock. Factors that contribute to the pathogenesis of UPEC include; secreted proteins, haemolysins, capsule, lipopolysaccharides, biofilm, fimbriae adhesions and iron acquisition systems. In spite of several host protection mechanisms; however, UPEC may persist inside the urinary tract and serve as a reservoir of recurrent infections and complications. Early diagnosis and prompt treatment of UTI with broad spectrum antibiotics are essential before this infection causes other medical complications. Generally, in clinical settings, diagnosis of UTIs involves bacterial culture and antibiotic susceptibility assay, in addition to other medical examinations, which aid the physicians to prescribe the appropriate drugs and measures during UTIs treatments. This review aims to understand the epidemiology, pathogenesis, clinical manifestation, diagnosis, treatment and preventive measures of UTIs caused by the uropathogenic E. coli.