As infecções do trato urinário (ITUs) são uma das causas mais comuns de consultas médicas. No ambiente hospitalar estão entre as mais frequentes infecções relacionadas à assistência à saúde (35 a 45%). Nos Estados Unidos da América, resultam em 3.600.000 consultas médicas anuais e mais de 100.000 hospitalizações. No Reino Unido, representam 23% das infecções relacionadas à assistência à saúde. Estudos mostram que a E. coli é a bactéria mais isolada em uroculturas (75% a 80%), tanto em pacientes hospitalizados quanto não hospitalizados. A antibioticoterapia para ITU é comumente iniciada empiricamente, antes da urocultura e do antibiograma, por isso, faz-se necessário conhecer a sensibilidade e resistência dos prováveis agentes etiológicos, deve-se considerar o histórico clínico epidemiológico do paciente. No presente estudo foi realizada a análise da resistência das cepas de E. coli isoladas em 261 uroculturas de pacientes assistidos no serviço ambulatorial e hospitalar do Hospital Universitário Pedro Ernesto (HUPE) e, também, de 81 cepas isoladas em uroculturas de pacientes assistidos no serviço ambulatorial de um Hospital Maternidade do Município do Rio de Janeiro (HMMRJ), no período de maio de 2010 a dezembro de 2010. A susceptibilidade aos antimicrobianos foi determinada pela metodologia de disco difusão por Kirby e Bauer. Foram realizadas triagens fenotípicas para cepas produtoras de ESBL e para cepas produtoras de carbapenemases. Através dos dados contidos nos prontuários dos pacientes com uroculturas positivas para E. coli (≥ 105 ufc/mL), foi realizada a pesquisa clínica epidemiológica para se verificar a ocorrência de fatores de risco diversos, para ITU por E. coli. Observou-se que pacientes do sexo feminino são mais susceptíveis a ITU e o uso de antibiótico até 03 meses antes do episódio infeccioso (p= 0,04746), diabetes (p= 0,01683), trauma recente (p= 0,000238), cirurgia abdominal ou pélvica prévia (p= 0,00221), patologia crônica de bexiga (p= 0,002150), uso de cateter urinário (p=0,0002), insuficiência renal crônica (p= 0,02178), e hospitalização por até 06meses prévios (p= 0,01802) podem ser considerados fatores de risco para ITU por E. coli. Verificou-se que o uso de cateter urinário (p=0,000399), cirurgia abdominal ou pélvica prévia (p=0,004458) e o uso de antimicrobianos prévios ao processo infeccioso (p=0,002625), podem ser considerados fatores de risco importantes, para ITU por E. coli multirresistentes. Os pacientes do sexo masculino, apesar de minoria no estudo, representam a maioria dos pacientes com ITU por E. coli multirresistente. Verificou-se que a classe de antimicrobiano utilizado previamente ao episódio infeccioso, aumenta a chance de ocorrer ITU por E. coli multirresistente, principalmente quando associadas ao uso de cateter urinário e cirurgia abdominal ou pélvica prévia. Os perfis de resistência da cepas isoladas dos pacientes assistidos no serviço ambulatorial e hospitalar do HUPE apresentam semelhanças. Apesar do baixo número de cepas multirresistentes entre as isoladas dos pacientes assistidos no serviço ambulatorial do HMMRJ, essas apresentam perfil de resistência semelhante aos perfis das cepas isoladas dos pacientes assistidos no serviço ambulatorial e hospitalar do HUPE. A partir das evidências, percebe-se que o uso racional de antimicrobianos é muito importante para diminuir a problemática da resistência bacteriana / Urinary tract infections (UTIs) are one of the most common cause of medical visits. In the hospital setting, are the most common infections among health care associated infections (35 to 45%). In the United States of America, UTIs result in 3.6 million doctor visits annually and over 100,000 hospitalizations. In the UK, represent 23% of infections related to health care. Studies show that the bacterium E. coli is the most common microorganism isolated from urine cultures (75% to 80%), both in inpatients and in outpatients. Antibiotic treatment for UTI is usually initiated empirically before urine culture and antibiogram, so it is necessary to know the profile sensitivity and resistance of the likely etiologic agents and should consider clinical and epidemiological history of the patient. The present study was conducted to analyze the resistance of E. coli strains isolated from urine cultures in 261 patients assisted as outpatients and hospitalized patients at the Hospital Universitário Pedro Ernesto (HUPE) and also of 81 strains isolated in urine cultures of outpatients from a Municipal Maternity Hospital from Rio de Janeiro (MMHRJ), from May 2010 to December 2010. The antimicrobial susceptibility was determined by disk diffusion method of Kirby and Bauer. The phenotypic screening for ESBL production and confirmation of strains producing carbapenemases were performed. We conducted the clinical epidemiological research, using data contained in the records of patients with urine cultures positive for E. coli count ≥ 105 cfu / mL, to identify risk factors predisposing UTI by E. coli. It was observed that female patients are more suceptible to UTI and the use of antibiotics within 03 months before the infectious episode (p= 0,04746), diabetes (p= 0,01683), recent trauma (p= 0,000238), previous abdominal or pelvic surgery (p= 0,00221), chronic bladder disease (p= 0,002150), urinary catheter (p=0,0002), chronic renal failure (p= 0,02178), and previous hospitalization prior to 06 months (p= 0,01802), can be considered important risk factors for UTI by E. coli. And it was found that the use of urinary catheter (p=0,000399), abdominal or pelvic surgery (p=0,004458) and antibiotic use prior to the infectious process (p=0,002625) can be considered important risk factors for UTI by multidrug resistant E. coli. Although male patients represent the minority of patients with UTI, they represent the majority of patients with UTI by multidrug resistant E. coli, in the study. It was observed that the class of antimicrobial used within 03 months before the infectious episode enhances the chance of UTI by multidrug resistant E. coli, principally when associated to the use of urinary catheter and abdominal or pelvic surgery. The resistance profiles of strains isolated from outpatients and inpatients in the HUPE are similar. Althoug only a few multidrug strains were isolated from outpatients in the MMHRJ, they presented a resistance profile similar to the multidrug strains isolated from from outpatients and inpatients in the HUPE. Through the evidences, it is clear that the rational use of antimicrobials is very important to minimize the set of problems envolving the antimicrobial resistance

As infecções do trato urinário (ITUs) são uma das causas mais comuns de consultas médicas. No ambiente hospitalar estão entre as mais frequentes infecções relacionadas à assistência à saúde (35 a 45%). Nos Estados Unidos da América, resultam em 3.600.000 consultas médicas anuais e mais de 100.000 hospitalizações. No Reino Unido, representam 23% das infecções relacionadas à assistência à saúde. Estudos mostram que a E. coli é a bactéria mais isolada em uroculturas (75% a 80%), tanto em pacientes hospitalizados quanto não hospitalizados. A antibioticoterapia para ITU é comumente iniciada empiricamente, antes da urocultura e do antibiograma, por isso, faz-se necessário conhecer a sensibilidade e resistência dos prováveis agentes etiológicos, deve-se considerar o histórico clínico epidemiológico do paciente. No presente estudo foi realizada a análise da resistência das cepas de E. coli isoladas em 261 uroculturas de pacientes assistidos no serviço ambulatorial e hospitalar do Hospital Universitário Pedro Ernesto (HUPE) e, também, de 81 cepas isoladas em uroculturas de pacientes assistidos no serviço ambulatorial de um Hospital Maternidade do Município do Rio de Janeiro (HMMRJ), no período de maio de 2010 a dezembro de 2010. A susceptibilidade aos antimicrobianos foi determinada pela metodologia de disco difusão por Kirby e Bauer. Foram realizadas triagens fenotípicas para cepas produtoras de ESBL e para cepas produtoras de carbapenemases. Através dos dados contidos nos prontuários dos pacientes com uroculturas positivas para E. coli (≥ 105 ufc/mL), foi realizada a pesquisa clínica epidemiológica para se verificar a ocorrência de fatores de risco diversos, para ITU por E. coli. Observou-se que pacientes do sexo feminino são mais susceptíveis a ITU e o uso de antibiótico até 03 meses antes do episódio infeccioso (p= 0,04746), diabetes (p= 0,01683), trauma recente (p= 0,000238), cirurgia abdominal ou pélvica prévia (p= 0,00221), patologia crônica de bexiga (p= 0,002150), uso de cateter urinário (p=0,0002), insuficiência renal crônica (p= 0,02178), e hospitalização por até 06meses prévios (p= 0,01802) podem ser considerados fatores de risco para ITU por E. coli. Verificou-se que o uso de cateter urinário (p=0,000399), cirurgia abdominal ou pélvica prévia (p=0,004458) e o uso de antimicrobianos prévios ao processo infeccioso (p=0,002625), podem ser considerados fatores de risco importantes, para ITU por E. coli multirresistentes. Os pacientes do sexo masculino, apesar de minoria no estudo, representam a maioria dos pacientes com ITU por E. coli multirresistente. Verificou-se que a classe de antimicrobiano utilizado previamente ao episódio infeccioso, aumenta a chance de ocorrer ITU por E. coli multirresistente, principalmente quando associadas ao uso de cateter urinário e cirurgia abdominal ou pélvica prévia. Os perfis de resistência da cepas isoladas dos pacientes assistidos no serviço ambulatorial e hospitalar do HUPE apresentam semelhanças. Apesar do baixo número de cepas multirresistentes entre as isoladas dos pacientes assistidos no serviço ambulatorial do HMMRJ, essas apresentam perfil de resistência semelhante aos perfis das cepas isoladas dos pacientes assistidos no serviço ambulatorial e hospitalar do HUPE. A partir das evidências, percebe-se que o uso racional de antimicrobianos é muito importante para diminuir a problemática da resistência bacteriana / Urinary tract infections (UTIs) are one of the most common cause of medical visits. In the hospital setting, are the most common infections among health care associated infections (35 to 45%). In the United States of America, UTIs result in 3.6 million doctor visits annually and over 100,000 hospitalizations. In the UK, represent 23% of infections related to health care. Studies show that the bacterium E. coli is the most common microorganism isolated from urine cultures (75% to 80%), both in inpatients and in outpatients. Antibiotic treatment for UTI is usually initiated empirically before urine culture and antibiogram, so it is necessary to know the profile sensitivity and resistance of the likely etiologic agents and should consider clinical and epidemiological history of the patient. The present study was conducted to analyze the resistance of E. coli strains isolated from urine cultures in 261 patients assisted as outpatients and hospitalized patients at the Hospital Universitário Pedro Ernesto (HUPE) and also of 81 strains isolated in urine cultures of outpatients from a Municipal Maternity Hospital from Rio de Janeiro (MMHRJ), from May 2010 to December 2010. The antimicrobial susceptibility was determined by disk diffusion method of Kirby and Bauer. The phenotypic screening for ESBL production and confirmation of strains producing carbapenemases were performed. We conducted the clinical epidemiological research, using data contained in the records of patients with urine cultures positive for E. coli count ≥ 105 cfu / mL, to identify risk factors predisposing UTI by E. coli. It was observed that female patients are more suceptible to UTI and the use of antibiotics within 03 months before the infectious episode (p= 0,04746), diabetes (p= 0,01683), recent trauma (p= 0,000238), previous abdominal or pelvic surgery (p= 0,00221), chronic bladder disease (p= 0,002150), urinary catheter (p=0,0002), chronic renal failure (p= 0,02178), and previous hospitalization prior to 06 months (p= 0,01802), can be considered important risk factors for UTI by E. coli. And it was found that the use of urinary catheter (p=0,000399), abdominal or pelvic surgery (p=0,004458) and antibiotic use prior to the infectious process (p=0,002625) can be considered important risk factors for UTI by multidrug resistant E. coli. Although male patients represent the minority of patients with UTI, they represent the majority of patients with UTI by multidrug resistant E. coli, in the study. It was observed that the class of antimicrobial used within 03 months before the infectious episode enhances the chance of UTI by multidrug resistant E. coli, principally when associated to the use of urinary catheter and abdominal or pelvic surgery. The resistance profiles of strains isolated from outpatients and inpatients in the HUPE are similar. Althoug only a few multidrug strains were isolated from outpatients in the MMHRJ, they presented a resistance profile similar to the multidrug strains isolated from from outpatients and inpatients in the HUPE. Through the evidences, it is clear that the rational use of antimicrobials is very important to minimize the set of problems envolving the antimicrobial resistance

Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections and is caused by a range of different uropathogens, particularly by uropathogenic Escherichia coli (UPEC). Amongst the different virulence factors, biofilm formation and bacterial aggregation, often mediated by cell surface structures such as fimbriae, are common traits among uropathogens that cause CAUTI. In this study, a collection of UPEC isolates were screened for virulence genes and phenotypes associated with urinary tract infections such as biofilm formation and mannose-sensitive haemagglutination. Two strains, E. coli MS2027 (which formed a strong biofilm) and E. coli M184 (which aggregated strongly) were analysed in detail to determine the molecular mechanisms associated with these phenotypes. Transposon mutagenesis of E. coli MS2027 identified type 3 fimbriae as the factor responsible for its strong biofilm growth. Further screening revealed the presence of type 3 fimbriae in uropathogenic Citrobacter freundii, Citrobacter koseri, Klebsiella oxytoca, Klebsiella pneumoniae and other E. coli. Phylogenetic analysis of the type 3 fimbrial (mrkABCD) genes from these strains revealed they clustered into five distinct clades (A-E) ranging from one to twenty-three members. The majority of the sequences grouped in clade A, which was represented by the mrk gene cluster from the genome sequenced K. pneumoniae strain MGH78578. We demonstrated that type 3 fimbriae are functionally expressed by different Gram negative nosocomial pathogens and present evidence to suggest that they contribute significantly to catheter colonisation. The type 3 fimbrial genes from E. coli MS2027 were found to be located on a conjugative plasmid. Sequencing and annotation revealed that this 42,644 bp plasmid, named pMAS2027, contains 58 putative genes. Bioinformatic analysis identified pMAS2027 as an incompatibility X (IncX1) plasmid. Plasmid pMAS2027 contained genes encoding two important virulence factors, type 3 fimbriae and a type IV secretion (T4S) system. The biofilm ability was solely based on the expression of type 3 fimbriae and not the T4S system. The T4S system, however, accounted for the conjugative ability of pMAS2027. Differential tagging with fluorescent reporter genes demonstrated conjugative transfer of pMAS2027 between cells during biofilm growth. Finaly, transposon mutagenesis of E. coli M184 revealed a number of putative genes potentially responsible for bacterial aggregation. Of these, genes involved in the synthesis of the enterobacterial common antigen (ECA) were shown to be associated with an aggregation phenotype.

Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections and is caused by a range of different uropathogens, particularly by uropathogenic Escherichia coli (UPEC). Amongst the different virulence factors, biofilm formation and bacterial aggregation, often mediated by cell surface structures such as fimbriae, are common traits among uropathogens that cause CAUTI. In this study, a collection of UPEC isolates were screened for virulence genes and phenotypes associated with urinary tract infections such as biofilm formation and mannose-sensitive haemagglutination. Two strains, E. coli MS2027 (which formed a strong biofilm) and E. coli M184 (which aggregated strongly) were analysed in detail to determine the molecular mechanisms associated with these phenotypes. Transposon mutagenesis of E. coli MS2027 identified type 3 fimbriae as the factor responsible for its strong biofilm growth. Further screening revealed the presence of type 3 fimbriae in uropathogenic Citrobacter freundii, Citrobacter koseri, Klebsiella oxytoca, Klebsiella pneumoniae and other E. coli. Phylogenetic analysis of the type 3 fimbrial (mrkABCD) genes from these strains revealed they clustered into five distinct clades (A-E) ranging from one to twenty-three members. The majority of the sequences grouped in clade A, which was represented by the mrk gene cluster from the genome sequenced K. pneumoniae strain MGH78578. We demonstrated that type 3 fimbriae are functionally expressed by different Gram negative nosocomial pathogens and present evidence to suggest that they contribute significantly to catheter colonisation. The type 3 fimbrial genes from E. coli MS2027 were found to be located on a conjugative plasmid. Sequencing and annotation revealed that this 42,644 bp plasmid, named pMAS2027, contains 58 putative genes. Bioinformatic analysis identified pMAS2027 as an incompatibility X (IncX1) plasmid. Plasmid pMAS2027 contained genes encoding two important virulence factors, type 3 fimbriae and a type IV secretion (T4S) system. The biofilm ability was solely based on the expression of type 3 fimbriae and not the T4S system. The T4S system, however, accounted for the conjugative ability of pMAS2027. Differential tagging with fluorescent reporter genes demonstrated conjugative transfer of pMAS2027 between cells during biofilm growth. Finaly, transposon mutagenesis of E. coli M184 revealed a number of putative genes potentially responsible for bacterial aggregation. Of these, genes involved in the synthesis of the enterobacterial common antigen (ECA) were shown to be associated with an aggregation phenotype.

Catheter-associated urinary tract infection (CAUTI) is one of the most common nosocomial infections and is caused by a range of different uropathogens, particularly by uropathogenic Escherichia coli (UPEC). Amongst the different virulence factors, biofilm formation and bacterial aggregation, often mediated by cell surface structures such as fimbriae, are common traits among uropathogens that cause CAUTI. In this study, a collection of UPEC isolates were screened for virulence genes and phenotypes associated with urinary tract infections such as biofilm formation and mannose-sensitive haemagglutination. Two strains, E. coli MS2027 (which formed a strong biofilm) and E. coli M184 (which aggregated strongly) were analysed in detail to determine the molecular mechanisms associated with these phenotypes. Transposon mutagenesis of E. coli MS2027 identified type 3 fimbriae as the factor responsible for its strong biofilm growth. Further screening revealed the presence of type 3 fimbriae in uropathogenic Citrobacter freundii, Citrobacter koseri, Klebsiella oxytoca, Klebsiella pneumoniae and other E. coli. Phylogenetic analysis of the type 3 fimbrial (mrkABCD) genes from these strains revealed they clustered into five distinct clades (A-E) ranging from one to twenty-three members. The majority of the sequences grouped in clade A, which was represented by the mrk gene cluster from the genome sequenced K. pneumoniae strain MGH78578. We demonstrated that type 3 fimbriae are functionally expressed by different Gram negative nosocomial pathogens and present evidence to suggest that they contribute significantly to catheter colonisation. The type 3 fimbrial genes from E. coli MS2027 were found to be located on a conjugative plasmid. Sequencing and annotation revealed that this 42,644 bp plasmid, named pMAS2027, contains 58 putative genes. Bioinformatic analysis identified pMAS2027 as an incompatibility X (IncX1) plasmid. Plasmid pMAS2027 contained genes encoding two important virulence factors, type 3 fimbriae and a type IV secretion (T4S) system. The biofilm ability was solely based on the expression of type 3 fimbriae and not the T4S system. The T4S system, however, accounted for the conjugative ability of pMAS2027. Differential tagging with fluorescent reporter genes demonstrated conjugative transfer of pMAS2027 between cells during biofilm growth. Finaly, transposon mutagenesis of E. coli M184 revealed a number of putative genes potentially responsible for bacterial aggregation. Of these, genes involved in the synthesis of the enterobacterial common antigen (ECA) were shown to be associated with an aggregation phenotype.

Uropathogenic Escherichia coli is a leading cause of urinary tract infections and bacterial prostatitis, the most common UTI complication in men. The initial stages of a successful infection involve bacterial adhesion to host cells through specialized adhesins. FimH, a protein located at the tip of type 1 pili, plays a crucial role as the main mediator for UPEC binding to bladder cells. While the host partners of FimH in the bladder are well-established, the interactions between FimH and prostate cells remain elusive. Consequently, the overarching goal is to enhance comprehension of the initial steps in prostate infection by investigating the interaction of FimH with prostate proteins. To achieve this, a recombinant FimH was constructed and expressed in an inducible expression vector, and an immunofluorescence staining assay was performed which demonstrated distinctive binding patterns in prostate cells compared to the bladder cell line. A Far Western overlay assay, revealed six distinct protein bands in human prostate cells and two in mouse prostate cells, indicating different potential protein partners. These interactions were examined under native conditions by establishing and optimizing a co-immunoprecipitation assay with cell proteins derived from both human and mouse prostates, with the 5637 cell line serving as a positive control. In summary, this study reveals striking differences between FimH binding to prostate and bladder cells, emphasizing the importance of FimH in adhesion and the need for further exploration of FimH interaction with prostate cells.

A bactéria Escherichia coli é responsável por perdas econômicas significativas mundialmente, incluindo-se aquelas que ocorrem na produção avícola. O controle e a prevenção da colibacilose aviária são complexos, pois envolve a distinção de isolados que comumente habitam o trato gastrointestinal das aves daquelas consideradas patogênicas. Embora tenha sido assumido que a maioria dos isolados não possui potencial zoonótico, estudos recentes têm sugerido que isolados isoladas de humanos e de aves poderiam compartilhar o maquinário genético necessário para causar a doença no hospedeiro. Desta forma, os animais de produção poderiam atuar como reservatórios de estirpes potencialmente patogênicas para humanos. O objetivo deste trabalho foi realizar a caracterização molecular em grupos filogenéticos de E. coli isoladas de aves (APEC) e de humanos (UPEC) e propor um futuro acompanhamento da flutuação da patogenicidade dos isolados APEC em planteis avícolas. Foram selecionadas 450 isolados UPEC e 460 APEC para classificação em quatro grupos filogenéticos (A, B1, B2 e D) através de um protocolo de multiplex-PCR. Estes resultados foram comparados com a presença ou ausência de 38 genes associados à virulência e com o índice de patogenicidade in vivo estabelecido para cada isolado em estudo anterior. Em relação aos isolados APEC, 31,1% foram classificadas no grupo D, 25,2% no grupo B2, 24,1% no grupo B1 e 19,6% no grupo A. Entre os isolados UPEC, 53,6% das foram classificadas no grupo B2, 25,3% no grupo D, 15,1% no grupo A e apenas 6,0% no grupo B1. Os isolados virulentos geralmente classificam-se no grupo B2, porém algumas podem ser classificadas no grupo D. Enquanto que os isolados comensais em geral pertencem aos grupos A e B1. Observou-se associação entre determinados genes e os grupos filogenéticos, tanto para isolados APEC quanto UPEC. Observou-se diferença significativa entre os índices de patogenicidade conforme a fonte de isolamento, sendo que os isolados de lesões apresentaram os maiores índices. Também foi observada uma associação direta entre os índices de patogenicidade obtidos in vivo e os grupos filogenéticos. Os isolados do grupo B2 e D apresentaram maiores índices em relação aos isolados B1 e A. Uma vez que a distribuição dos isolados APEC nos grupos filogenéticos apresentou associação significativa com a patogenicidade, o multiplex-PCR torna-se uma importante ferramenta disponível para o screening da patogenicidade das amostras isoladas na cadeia avícola. / Escherichia coli is responsible for significant economic losses, including those occurring in poultry production. The control and prevention of avian colibacillosis are complex because it involves the distinction of pathogenic strains and those that are commonly found in the gastrointestinal tract flora of health birds. Although it has been assumed that most strains do not have zoonotic potential, recent studies have suggested that strains isolated from humans and poultry could share the genetic machinery needed to cause the disease in the host. Therefore, production animals could act as reservoirs of strains potentially pathogenic to humans. The aim of this study was to carry out the molecular characterization in phylogenetic groups of strains of E. coli isolated from poultry (APEC) and humans (UPEC), and to propose a future monitoring of the pathogenicity of APEC strains in poultry farms. A total of 450 UPEC and 460 APEC strains were selected for classification into four phylogenetic groups (A, B1, B2 and D) using a multiplex-PCR protocol. These results were compared with the presence or absence of 38 virulence-associated genes and the in vivo pathogenicity index established for each strain in a previous study. Regarding the APEC strains, 31.1% were classified in group D, 25.2% in group B2, 24.1% in group B1 and 19.6% in group A. Among the UPEC strains, 53.6% were classified in group B2, 25.3% in group D, 15.1% in group A and only 6.0% in group B1. Virulent strains are generally classified in group B2, but some may be classified in group D. While commensal isolates generally belong to groups A or B1. It was observed an association between certain genes and phylogenetic groups, both for APEC and UPEC strains. A significant difference was observed among pathogenicity indices according to the source of isolation, and the strains isolated from lesions presented the highest indices. A direct association between pathogenicity indices obtained in vivo and phylogenetic groups was also observed. Strains of groups B2 and D showed higher indices compared to strains from B1 and A. Since the distribution of APEC strains in phylogenetic groups showed a significant association with pathogenicity, multiplex-PCR becomes an important tool available for screening pathogenicity of the isolated samples in the poultry chain.

A bactéria Escherichia coli é responsável por perdas econômicas significativas mundialmente, incluindo-se aquelas que ocorrem na produção avícola. O controle e a prevenção da colibacilose aviária são complexos, pois envolve a distinção de isolados que comumente habitam o trato gastrointestinal das aves daquelas consideradas patogênicas. Embora tenha sido assumido que a maioria dos isolados não possui potencial zoonótico, estudos recentes têm sugerido que isolados isoladas de humanos e de aves poderiam compartilhar o maquinário genético necessário para causar a doença no hospedeiro. Desta forma, os animais de produção poderiam atuar como reservatórios de estirpes potencialmente patogênicas para humanos. O objetivo deste trabalho foi realizar a caracterização molecular em grupos filogenéticos de E. coli isoladas de aves (APEC) e de humanos (UPEC) e propor um futuro acompanhamento da flutuação da patogenicidade dos isolados APEC em planteis avícolas. Foram selecionadas 450 isolados UPEC e 460 APEC para classificação em quatro grupos filogenéticos (A, B1, B2 e D) através de um protocolo de multiplex-PCR. Estes resultados foram comparados com a presença ou ausência de 38 genes associados à virulência e com o índice de patogenicidade in vivo estabelecido para cada isolado em estudo anterior. Em relação aos isolados APEC, 31,1% foram classificadas no grupo D, 25,2% no grupo B2, 24,1% no grupo B1 e 19,6% no grupo A. Entre os isolados UPEC, 53,6% das foram classificadas no grupo B2, 25,3% no grupo D, 15,1% no grupo A e apenas 6,0% no grupo B1. Os isolados virulentos geralmente classificam-se no grupo B2, porém algumas podem ser classificadas no grupo D. Enquanto que os isolados comensais em geral pertencem aos grupos A e B1. Observou-se associação entre determinados genes e os grupos filogenéticos, tanto para isolados APEC quanto UPEC. Observou-se diferença significativa entre os índices de patogenicidade conforme a fonte de isolamento, sendo que os isolados de lesões apresentaram os maiores índices. Também foi observada uma associação direta entre os índices de patogenicidade obtidos in vivo e os grupos filogenéticos. Os isolados do grupo B2 e D apresentaram maiores índices em relação aos isolados B1 e A. Uma vez que a distribuição dos isolados APEC nos grupos filogenéticos apresentou associação significativa com a patogenicidade, o multiplex-PCR torna-se uma importante ferramenta disponível para o screening da patogenicidade das amostras isoladas na cadeia avícola. / Escherichia coli is responsible for significant economic losses, including those occurring in poultry production. The control and prevention of avian colibacillosis are complex because it involves the distinction of pathogenic strains and those that are commonly found in the gastrointestinal tract flora of health birds. Although it has been assumed that most strains do not have zoonotic potential, recent studies have suggested that strains isolated from humans and poultry could share the genetic machinery needed to cause the disease in the host. Therefore, production animals could act as reservoirs of strains potentially pathogenic to humans. The aim of this study was to carry out the molecular characterization in phylogenetic groups of strains of E. coli isolated from poultry (APEC) and humans (UPEC), and to propose a future monitoring of the pathogenicity of APEC strains in poultry farms. A total of 450 UPEC and 460 APEC strains were selected for classification into four phylogenetic groups (A, B1, B2 and D) using a multiplex-PCR protocol. These results were compared with the presence or absence of 38 virulence-associated genes and the in vivo pathogenicity index established for each strain in a previous study. Regarding the APEC strains, 31.1% were classified in group D, 25.2% in group B2, 24.1% in group B1 and 19.6% in group A. Among the UPEC strains, 53.6% were classified in group B2, 25.3% in group D, 15.1% in group A and only 6.0% in group B1. Virulent strains are generally classified in group B2, but some may be classified in group D. While commensal isolates generally belong to groups A or B1. It was observed an association between certain genes and phylogenetic groups, both for APEC and UPEC strains. A significant difference was observed among pathogenicity indices according to the source of isolation, and the strains isolated from lesions presented the highest indices. A direct association between pathogenicity indices obtained in vivo and phylogenetic groups was also observed. Strains of groups B2 and D showed higher indices compared to strains from B1 and A. Since the distribution of APEC strains in phylogenetic groups showed a significant association with pathogenicity, multiplex-PCR becomes an important tool available for screening pathogenicity of the isolated samples in the poultry chain.

A bactéria Escherichia coli é responsável por perdas econômicas significativas mundialmente, incluindo-se aquelas que ocorrem na produção avícola. O controle e a prevenção da colibacilose aviária são complexos, pois envolve a distinção de isolados que comumente habitam o trato gastrointestinal das aves daquelas consideradas patogênicas. Embora tenha sido assumido que a maioria dos isolados não possui potencial zoonótico, estudos recentes têm sugerido que isolados isoladas de humanos e de aves poderiam compartilhar o maquinário genético necessário para causar a doença no hospedeiro. Desta forma, os animais de produção poderiam atuar como reservatórios de estirpes potencialmente patogênicas para humanos. O objetivo deste trabalho foi realizar a caracterização molecular em grupos filogenéticos de E. coli isoladas de aves (APEC) e de humanos (UPEC) e propor um futuro acompanhamento da flutuação da patogenicidade dos isolados APEC em planteis avícolas. Foram selecionadas 450 isolados UPEC e 460 APEC para classificação em quatro grupos filogenéticos (A, B1, B2 e D) através de um protocolo de multiplex-PCR. Estes resultados foram comparados com a presença ou ausência de 38 genes associados à virulência e com o índice de patogenicidade in vivo estabelecido para cada isolado em estudo anterior. Em relação aos isolados APEC, 31,1% foram classificadas no grupo D, 25,2% no grupo B2, 24,1% no grupo B1 e 19,6% no grupo A. Entre os isolados UPEC, 53,6% das foram classificadas no grupo B2, 25,3% no grupo D, 15,1% no grupo A e apenas 6,0% no grupo B1. Os isolados virulentos geralmente classificam-se no grupo B2, porém algumas podem ser classificadas no grupo D. Enquanto que os isolados comensais em geral pertencem aos grupos A e B1. Observou-se associação entre determinados genes e os grupos filogenéticos, tanto para isolados APEC quanto UPEC. Observou-se diferença significativa entre os índices de patogenicidade conforme a fonte de isolamento, sendo que os isolados de lesões apresentaram os maiores índices. Também foi observada uma associação direta entre os índices de patogenicidade obtidos in vivo e os grupos filogenéticos. Os isolados do grupo B2 e D apresentaram maiores índices em relação aos isolados B1 e A. Uma vez que a distribuição dos isolados APEC nos grupos filogenéticos apresentou associação significativa com a patogenicidade, o multiplex-PCR torna-se uma importante ferramenta disponível para o screening da patogenicidade das amostras isoladas na cadeia avícola. / Escherichia coli is responsible for significant economic losses, including those occurring in poultry production. The control and prevention of avian colibacillosis are complex because it involves the distinction of pathogenic strains and those that are commonly found in the gastrointestinal tract flora of health birds. Although it has been assumed that most strains do not have zoonotic potential, recent studies have suggested that strains isolated from humans and poultry could share the genetic machinery needed to cause the disease in the host. Therefore, production animals could act as reservoirs of strains potentially pathogenic to humans. The aim of this study was to carry out the molecular characterization in phylogenetic groups of strains of E. coli isolated from poultry (APEC) and humans (UPEC), and to propose a future monitoring of the pathogenicity of APEC strains in poultry farms. A total of 450 UPEC and 460 APEC strains were selected for classification into four phylogenetic groups (A, B1, B2 and D) using a multiplex-PCR protocol. These results were compared with the presence or absence of 38 virulence-associated genes and the in vivo pathogenicity index established for each strain in a previous study. Regarding the APEC strains, 31.1% were classified in group D, 25.2% in group B2, 24.1% in group B1 and 19.6% in group A. Among the UPEC strains, 53.6% were classified in group B2, 25.3% in group D, 15.1% in group A and only 6.0% in group B1. Virulent strains are generally classified in group B2, but some may be classified in group D. While commensal isolates generally belong to groups A or B1. It was observed an association between certain genes and phylogenetic groups, both for APEC and UPEC strains. A significant difference was observed among pathogenicity indices according to the source of isolation, and the strains isolated from lesions presented the highest indices. A direct association between pathogenicity indices obtained in vivo and phylogenetic groups was also observed. Strains of groups B2 and D showed higher indices compared to strains from B1 and A. Since the distribution of APEC strains in phylogenetic groups showed a significant association with pathogenicity, multiplex-PCR becomes an important tool available for screening pathogenicity of the isolated samples in the poultry chain.

<p>Urinary tract infections (UTIs) are typically caused by bacteria that colonize different regions of the urinary tract, mainly the bladder and the kidney. Approximately 25% of women that suffer from UTIs experience a recurrent infection within 6 months of the initial bout, making UTIs a serious economic burden resulting in more than 10 million hospital visits and $3.5 billion in healthcare costs in the United States alone. Type-1 fimbriated Uropathogenic E. coli (UPEC) is the major causative agent of UTIs, accounting for almost 90 % of bacterial UTIs. The unique ability of UPEC to bind and invade the superficial bladder epithelium allows the bacteria to persist inside epithelial niches and survive antibiotic treatment. Persistent, intracellular UPEC are retained in the bladder epithelium for long periods, making them a source of recurrent UTIs. Hence, the ability of UPEC to persist in the bladder is a matter of major health and economic concern, making studies exploring the underlying mechanism of UPEC persistence highly relevant. </p><p>In my thesis, I will describe how intracellular Uropathogenic E.coli (UPEC) evade host defense mechanisms in the superficial bladder epithelium. I will also describe some of the unique traits of persistent UPEC and explore strategies to induce their clearance from the bladder. I have discovered that the UPEC virulence factor Alpha-hemolysin (HlyA) plays a key role in the survival and persistence of UPEC in the superficial bladder epithelium. In-vitro and in-vivo studies comparing intracellular survival of wild type (WT) and hemolysin deficient UPEC suggested that HlyA is vital for UPEC persistence in the superficial bladder epithelium. Further in-vitro studies revealed that hemolysin helped UPEC persist intracellularly by evading the bacterial expulsion actions of the bladder cells and remarkably, this virulence factor also helped bacteria avoid t degradation in lysosomes. </p><p>To elucidate the mechanistic basis for how hemolysin promotes UPEC persistence in the urothelium, we initially focused on how hemolysin facilitates the evasion of UPEC expulsion from bladder cells. We found that upon entry, UPEC were encased in “exocytic vesicles” but as a result of HlyA expression these bacteria escaped these vesicles and entered the cytosol. Consequently, these bacteria were able to avoid expulsion by the cellular export machinery. </p><p>Since bacteria found in the cytosol of host cells are typically recognized by the cellular autophagy pathway and transported to the lysosomes where they are degraded, we explored why this was not the case here. We observed that although cytosolic HlyA expressing UPEC were recognized and encased by the autophagy system and transported to lysosomes, the bacteria appeared to avoid degradation in these normally degradative compartments. A closer examination of the bacteria containing lysosomes revealed that they lacked V-ATPase. V-ATPase is a well-known proton pump essential for the acidification of mammalian intracellular degradative compartments, allowing for the proper functioning of degradative proteases. The absence of V-ATPase appeared to be due to hemolysin mediated alteration of the bladder cell F-actin network. From these studies, it is clear that UPEC hemolysin facilitates UPEC persistence in the superficial bladder epithelium by helping bacteria avoid expulsion by the exocytic machinery of the cell and at the same time enabling the bacteria avoid degradation when the bacteria are shuttled into the lysosomes. </p><p>Interestingly even though UPEC appear to avoid elimination from the bladder cell their ability to multiple in bladder cells seem limited.. Indeed, our in-vitro and in-vivo experiments reveal that UPEC survive in superficial bladder epithelium for extended periods of time without a significantly change in CFU numbers. Indeed, we observed these bacteria appeared quiescent in nature. This observation was supported by the observation that UPEC genetically unable to enter a quiescence phase exhibited limited ability to persist in bladder cells in vitro and in vivo, in the mouse bladder. </p><p>The studies elucidated in this thesis reveal how UPEC toxin, Alpha-hemolysin plays a significant role in promoting UPEC persistence via the modulation of the vesicular compartmentalization of UPEC at two different stages of the infection in the superficial bladder epithelium. These results highlight the importance of UPEC Alpha-hemolysin as an essential determinant of UPEC persistence in the urinary bladder.</p> / Dissertation