Tara L. Vollmerhausen

Antimicrobial resistance and distribution of sul genes and integron-associated intI genes among uropathogenic Escherichia coli in Queensland, Australia

We studied 137 uropathogenic Escherichia coli (UPEC) isolates from hospitalized adult patients (Queensland, Australia) for their resistance to 17 antimicrobial agents using the calibrated dichotomous sensitivity method and the presence of class I, II and III integron-associated integrase (intI) genes, including functional class II intI2, as well as the presence of sul1, sul2 and sul3 genes, using PCR. Randomly amplified polymorphic DNA PCR, a high-resolution biochemical-fingerprinting method (PhP) and phylogenetic grouping were also used to identify the clonality of the sulphonamide-resistant isolates. One hundred and twenty (87.6 %) isolates were resistant to one or more of the tested antimicrobial drugs, with the highest resistance (70.1 %) observed against sulphafurazole (96 isolates). Of these, 84 (87.5 %) contained one or more sul alleles, with sul1 being the most common allele [occurring in 69 (72 %) isolates]. Only 38 of 69 (55.1 %) strains carrying the sul1 gene were positive for class I integrase. Our results indicate a high prevalence of sulphafurazole-resistant UPEC strains belonging to different clones among patients with urinary tract infection in Queensland, Australia. We also conclude that these strains carry predominantly a sul1 gene that is not commonly associated with the presence of class I integrase, indicating that it may be carried on either a bacterial chromosome or other genetic elements.

Prevalence and Persistence of Escherichia coli Strains with Uropathogenic Virulence Characteristics in Sewage Treatment Plants

ABSTRACT We investigated the prevalence and persistence of Escherichia coli strains in four sewage treatment plants (STPs) in a subtropical region of Queensland, Australia. In all, 264 E. coli strains were typed using a high-resolution biochemical fingerprinting method and grouped into either a single or a common biochemical phenotype (S-BPT and C-BPT, respectively). These strains were also tested for their phylogenetic groups and 12 virulence genes associated with intestinal and extraintestinal E. coli strains. Comparison of BPTs at various treatment stages indicated that certain BPTs were found in two or all treatment stages. These BPTs constituted the highest proportion of E. coli strains in each STP and belonged mainly to phylogenetic group B2 and, to a lesser extent, group D. No virulence genes associated with intestinal E. coli were found among the strains, but 157 (59.5%) strains belonging to 14 C-BPTs carried one or more virulence genes associated with uropathogenic strains. Of these, 120 (76.4%) strains belonged to seven persistent C-BPTs and were found in all four STPs. Our results indicate that certain clonal groups of E. coli with virulence characteristics of uropathogenic strains can survive the treatment processes of STPs. These strains were common to all STPs and constituted the highest proportion of the strains in different treatment tanks of each STP.

Population structure and uropathogenic virulence-associated genes of faecal Escherichia coli from healthy young and elderly adults.

We investigated the population structures of faecal Escherichia coli in 30 healthy young adults (13 males and 17 females) aged between 20 and 45 years and 29 elderly adults (14 females and 15 males) aged between 65 and 77 years. In all, 1566 strains were typed with the PhPlate system and grouped into biochemical phenotypes (BPTs). Strains with shared BPTs were further typed using randomly amplified polymorphic DNA analysis. Forty-four per cent of the strains were shared between two or more age and gender groups. Elders had a significantly higher (P<0.001) number of BPTs (mean±standard error 3.3±0.27) than younger groups (1.82±0.27). Phylogenetic affiliation and virulence-associated genes (VAGs) of the strains showed that more than 80 % of the strains belonging to dominant types belonged to phylogroups B2 and D. Amongst dominant BPTs, phylogenetic group A was significantly associated with females (P<0.0001), and elders were more likely to carry group D (P<0.0124). Elderly males had a higher prevalence of VAGs than young males (P<0.0001) and young females (P<0.0005). We conclude that there is a lower prevalence of E. coli with uropathogenic properties in healthy young adults than in elders.

Decoctions from Citrus reticulata Blanco seeds protect the uroepithelium against Escherichia coli invasion.

ETHNOPHARMACOLOGICAL RELEVANCE Traditional usage suggests Citrus reticulata Blanco seeds have beneficial effects against infection. The purpose of this study was to investigate the effect of Citrus reticulata on the uroepithelium and to determine the mechanisms responsible for protection against urinary tract infection (UTI). MATERIALS AND METHODS Human bladder cell lines T24 and 5637 were employed in a cell culture infection model to determine the effects of Citrus reticulata treatment on Escherichia coli adherence and invasion of the uroepithelium. β1 integrin and caveolin-1 mRNA expression was assessed using RT real-time PCR. β1 integrin protein expression was confirmed by Western Blot. The effect of Citrus reticulata on bacteria was investigated using antibacterial sensitivity, yeast agglutination and biofilm assays. RESULTS Citrus reticulata treatment decreased β1 integrin expression and reduced bacterial invasion while adhesion of uroepithelial cells was not affected. Caveolin-1 expression was not influenced either and Citrus reticulata did neither exhibit any direct antimicrobial effect nor interfered with type 1 fimbriae binding. CONCLUSIONS Our results show that Citrus reticulata has a protective effect on the uroepithelium as seen by reduced bacterial invasion of uroepithelial cells. These properties suggest that seeds from Citrus reticulata may have therapeutic potential in preventing UTI.

Visible and UVA light as a potential means of preventing Escherichia coli biofilm formation in urine and on materials used in urethral catheters

Catheter-associated urinary tract infections are the most common hospital-acquired infection, for which Escherichia coli is the leading cause. This study investigated the efficacy of 385nm and 420nm light for inactivation of E. coli attached to the silicone matrix of a urinary catheter. Using urine mucin media, inactivation of planktonic bacteria and biofilm formation was monitored using silicone coupons. Continuous irradiance with both 385nm and 420nm wavelengths with starting cell density population 103CFU ml-1 reduced planktonic suspensions of E. coli to below the detection level after 2h and 6h, respectively. Bacterial attachment to silicone was successfully prevented during the same treatment. Inactivation by 385nm and 420nm was found to be dependent on media, cell density and oxygen, with less inhibition on planktonic suspensions when higher starting cell densities were used. In contrast to planktonic suspensions in PBS, continuous irradiance of pre-established biofilms showed a greater reduction in survival compared to urine mucin media after 24h. Enhanced inhibition for 385nm and 420nm light in urine mucin media was associated with increased production of reactive oxygen species. These findings suggest 385nm and 420nm light as a promising antimicrobial technology for the prevention of biofilm formation on urethral catheters.

Interactions of uroseptic escherichia coli with renal (A-498) and gastrointestinal (HT-29) cell lines

We investigated the ability of Escherichia coli isolated from septic patients with urinary tract infection (UTI) to translocate through the gastrointestinal (GI) tract of the same patients using cell-culture models. Forty-seven hospitalized patients with urosepsis were included in this study. E. coli was isolated from their urine and blood (total 94 isolates) and investigated for genetic relatedness and interaction with the cell lines A-498 and HT-29. An initial comparison of the strains isolated from urine and blood showed that 44 out of 47 patients (94 %) had identical strains in their blood and urine. The blood isolates adhered to both cell lines, although their rate of adherence to A-498 cells was significantly higher than that to HT-29 cells (5.8±3.8 per cell vs 2.8±1.9; P<0.0001). The rate of translocation in A-498 cells was also significantly higher after 120 min (8.7×10(5) vs 2.9×10(5); P = 0.0006). Three non-identical blood isolates were unable to translocate in HT-29 cells, indicating that host immune factors might be more important than bacterial ability to translocate the GI epithelium in these patients. Our data showed that blood isolates from uroseptic patients are able to adhere to and translocate through both cell lines. This suggests that E. coli in patients with UTI may translocate from either the GI tract or the urinary tract, hence questioning the assumption that the urinary tract is the only source of septicaemia in these patients.

Absence of Curli in Soil-Persistent Escherichia coli Is Mediated by a C-di-GMP Signaling Defect and Suggests Evidence of Biofilm-Independent Niche Specialization

Escherichia coli is commonly viewed as a gastrointestinal commensal or pathogen although an increasing body of evidence suggests that it can persist in non-host environments as well. Curli are a major component of biofilm in many enteric bacteria including E. coli and are important for adherence to different biotic and abiotic surfaces. In this study we investigated curli production in a unique collection of soil-persistent E. coli isolates and examined the role of curli formation in environmental persistence. Although most soil-persistent E. coli were curli-positive, 10% of isolates were curli-negative (17 out of 170). Curli-producing E. coli (COB583, COB585, and BW25113) displayed significantly more attachment to quartz sand than the curli-negative strains. Long-term soil survival experiments indicated that curli production was not required for long-term survival in live soil (over 110 days), as a curli-negative mutant BW25113ΔcsgB had similar survival compared to wild type BW25113. Mutations in two genes associated with c-di-GMP metabolism, dgcE and pdeR, correlated with loss of curli in eight soil-persistent strains, although this did not significantly impair their survival in soil compared to curli-positive strains. Overall, the data indicate that curli-deficient and biofilm-defective strains, that also have a defect in attachment to quartz sand, are able to reside in soil for long periods of time thus pointing to the possibility that niches may exist in the soil that can support long-term survival independently of biofilm formation.

Assessing the population dynamics of Escherichia coli in a metropolitan river after an extreme flood event

We investigated Escherichia coli populations in a metropolitan river after an extreme flood event. Between nine and 15 of the 23 selected sites along the river were sampled fortnightly over three rounds. In all, 307 E. coli were typed using the PhP typing method and were grouped into common (C) or single (S) biochemical phenotypes (BPTs). A representative from each of the 31 identified C-BPTs was tested for 58 virulence genes (VGs) associated with intestinal and extra-intestinal E. coli, resistance to 22 antibiotics, production of biofilm and cytotoxicity to Vero cells. The number of E. coli in the first sampling round was significantly (P < 0.01) higher than subsequent rounds, whereas the number of VGs was significantly (P < 0.05) higher in isolates from the last sampling round when compared to previous rounds. Comparison of the C-BPTs with an existing database from wastewater treatment plants (WWTPs) in the same catchment showed that 40.6% of the river isolates were identical to the WWTP isolates. The relatively high number of VGs and antibiotic resistance among the C-BPTs suggests possessing and retaining these genes may provide niche advantages for those naturalised and/or persistent E. coli populations which may pose a health risk to the community.

Invasion and translocation of uropathogenic Escherichia coli isolated from urosepsis and patients with community-acquired urinary tract infection.

Uropathogenic Escherichia coli (UPEC) strains are found in high numbers in the gut of patients with urinary tract infections (UTIs). We hypothesised that in hospitalised patients, UPEC strains might translocate from the gut to the blood stream and that this could be due to the presence of virulence genes (VGs) that are not commonly found in UPEC strains that cause UTI only. To test this, E. coli strains representing 75 dominant clonal groups of UPEC isolated from the blood of hospitalised patients with UTI (urosepsis) (n = 22), hospital-acquired (HA) UTI without blood infection (n = 24) and strains isolated from patients with community-acquired (CA)-UTIs (n = 29) were tested for their adhesion to, invasion and translocation through Caco-2 cells, in addition to the presence of 34 VGs associated with UPEC. Although there were no differences in the rate and degree of translocation among the groups, urosepsis and HA-UTI strains showed significantly higher abilities to adhere (P = 0.0095 and P < 0.0001 respectively) and invade Caco-2 cells than CA-UTI isolates (P = 0.0044, P = 0.0048 respectively). Urosepsis strains also carried significantly more VGs than strains isolated from patients with only UTI and/or CA-UTI isolates. In contrast, the antigen 43 allele RS218 was found more commonly among CA-UTI strains than in the other two groups. These data indicate that UPEC strains, irrespective of their source, are capable of translocating through gut epithelium. However, urosepsis and HA-UTI strains have a much better ability to interact with gut epithelia and have a greater virulence potential than CA-UPEC, which allows them to cause blood infection.

Exploring the Potential of Light to Prevent and Treat Microbial Biofilms in Medical and Food Applications

Biofilms are complex communities of microbial cells covered in an exopolysaccharide matrix and adhered to a surface. Colonization of medical devices is a significant problem in healthcare-associated infections, especially those related to implanted medical devices such as intravascular catheters and urinary catheters. Recent advances in light technology highlight the potential for light inhibition of biofilm formation in medical devices. This chapter reviews the microbial responses to light, mechanisms of photoinactivation, and some recent research on the use of light to eliminate biofilms. Although light holds a tremendous opportunity to treat antibiotic-resistant infections, challenges in relation to patient safety need to be evaluated. We also discuss some of the research aimed at translating the knowledge into clinical treatment of biofilm-associated infections.