Abstract
Objectives
To investigate the resistance and virulence profiles of uropathogenic Escherichia coli (UPEC) and its treatment by Chinese medicine (CM) Fuzheng Qingre Lishi Formula (扶正清热利湿方, FQLF).
Methods
UPEC strains were isolated from recurrent urinary tract infections (UTIs) patients. Patient sensitivities to 17 antibiotics were tested by the disk diffusion method. Virulence genes were screened by plolymerase chain reaction. A mouse model was constructed using a multi-drug resistant and virulent UPEC strain and treated with FQLF or the antibiotic imipenem. The treatment efficacy was evaluated by bacterial clearance from urine and the urinary organs.
Results
A total of 90 UPEC strains were collected, and 94.4% of the isolates were resistant to at least 1 antibiotic. Approximately 66.7% of the UPEC strains were multi-drug resistant. More than one virulence gene was found in 85.6% of the isolates. The extended-spectrum β-lactamases (ESBL)-positive strains were more resistant than the negative ones. The virulence gene number was positively correlated with the resistance number (P<0.05). A mouse model was successfully constructed using UPEC10. Treatment with either FQLF or antibiotics significantly cleared bacteria from the mouse urine after 14 days. In the untreated control, the bacteria lasted for 28 days. FQLF treatment of the UTI mouse model greatly reduced the bacterial number in the kidney and bladder, but could not completely clear the bacteria.
Conclusions
Multi-drug resistance is common among UPEC isolates, and the resistance is positively related with virulence. FQLF could treat UPEC UTIs, but could not completely clear the bacteria from the host.
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References
Foxman B. The epidemiology of urinary tract infection. Nature Rev Urol 2010;7:653–660.
Berger RE. Intracellular bacterial communities of uropathogenic escherichia coli in urinary tract pathogenesis. J Urol 2005;174:1843.
Johnson JR, Stell AL. Extended virulence genotypes of escherichia coli strains from patients with urosepsis in relation to phylogeny and host compromise. J Infect Dis 2000;181:261–272.
Zhang N, Huang L, Liu S, Wang Y, Luo Y, Jin X, et al. Traditional Chinese medicine: an alternative treatment option for refractory recurrent urinary tract infections. Clin Infect Dis 2013;56:1355.
Lu AP, Jia HW, Xiao C, Lu QP. Theory of traditional chinese medicine and therapeutic method of diseases. World J Gastroenterol 2004;10:1854–1856.
Hung CS, Dodson KW, Hultgren SJ. A murine model of urinary tract infection. Nature Protocols 2009;4:1230–1243.
Asadi Karam MR, Oloomi M, Mahdavi M, Habibi M, Bouzari S. Vaccination with recombinant fimh Fused with flagellin enhances cellular and humoral immunity against urinary tract infection in mice. Vaccine 2013;31:1210–1216.
Emo L, Kerenyi M, Nagy G. Virulence factors of uropathogenic escherichia coli. Int J Antimicr Agents 2003;22:29–33.
Anderson GG, Palermo JJ, Schilling JD, Roth R, Heuser J, Hultgren SJ. Intracellular bacterial biofilm-like pods in urinary tract infections. Science 2003;301:105–107.
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Supported by the National Key Program for Infectious Diseases of China (Nos. 2013ZX10004-203), National Natural Science Foundation of China (No. 81401646), Chinese Academy of Traditional Chinese Medicine Joint Innovation Research Project (No. ZZ070808), and Capital Featured Clinical Application and Product Promotion Project (No. Z151100004015132)
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Liu, Sw., Xu, Xy., Xu, J. et al. Multi-drug resistant uropathogenic Escherichia coli and its treatment by Chinese medicine. Chin. J. Integr. Med. 23, 763–769 (2017). https://doi.org/10.1007/s11655-016-2738-0
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DOI: https://doi.org/10.1007/s11655-016-2738-0