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PMID: 1672263 Published · ppublish English Journal Article Review

Virulence factors in Escherichia coli urinary tract infection.

Clinical microbiology reviews ·Vol. 4 ·No. 1 ·1991-01-00 ·Pages 80-128

Johnson JR

Abstract

Uropathogenic strains of Escherichia coli are characterized by the expression of distinctive bacterial properties, products, or structures referred to as virulence factors because they help the organism overcome host defenses and colonize or invade the urinary tract. Virulence factors of recognized importance in the pathogenesis of urinary tract infection (UTI) include adhesins (P fimbriae, certain other mannose-resistant adhesins, and type 1 fimbriae), the aerobactin system, hemolysin, K capsule, and resistance to serum killing. This review summarizes the virtual explosion of information regarding the epidemiology, biochemistry, mechanisms of action, and genetic basis of these urovirulence factors that has occurred in the past decade and identifies areas in need of further study. Virulence factor expression is more common among certain genetically related groups of E. coli which constitute virulent clones within the larger E. coli population. In general, the more virulence factors a strain expresses, the more severe an infection it is able to cause. Certain virulence factors specifically favor the development of pyelonephritis, others favor cystitis, and others favor asymptomatic bacteriuria. The currently defined virulence factors clearly contribute to the virulence of wild-type strains but are usually insufficient in themselves to transform an avirulent organism into a pathogen, demonstrating that other as-yet-undefined virulence properties await discovery. Virulence factor testing is a useful epidemiological and research tool but as yet has no defined clinical role. Immunological and biochemical anti-virulence factor interventions are effective in animal models of UTI and hold promise for the prevention of UTI in humans.

MeSH Terms
Adhesins, Escherichia coli Animals Antigens, Bacterial Antigens, Surface Bacterial Adhesion Bacterial Outer Membrane Proteins Blood Bactericidal Activity Escherichia coli/immunology,pathogenicity Escherichia coli Infections/microbiology Fimbriae, Bacterial Hemolysin Proteins Humans Hydroxamic Acids Virulence
Chemicals
Adhesins, Escherichia coli Antigens, Bacterial Antigens, Surface Bacterial Outer Membrane Proteins Hemolysin Proteins Hydroxamic Acids K antigens aerobactin
Authors & Affiliations
1 authors, click to expand affiliations / ORCID
Johnson J R
Department of Medicine, University of Minnesota Medical School, Minneapolis 55455.
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Article Info
Journal
Clinical microbiology reviews
Abbr.
Clin Microbiol Rev
ISSN
0893-8512
DOI
10.1128/CMR.4.1.80
Published
1991-01-00
Pages
80-128
Language
English
Region
United States
NLM ID
8807282
PMCID
PMC358180
Subset
IM
External Links
PubMed source DOI: 10.1128/CMR.4.1.80 PMC Full Text View journal details
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