Zusammenfassung
Im Gegensatz zu vielen kommensalen Bakterien sind uropathogene Erreger mit einer Vielzahl virulenzassoziierter Faktoren ausgestattet, die es ihnen ermöglichen verschiedene Bereiche des Harnwegstraktes zu infizieren. Verschiedene extra- oder intrazelluläre Lebensstile sind mit akuten oder rekurrierenden Harnwegsinfektionen verbunden. Adhäsine vermitteln die Interaktion mit Urothelzellen und fördern die bakterielle Adhäsion oder Invasion sowie die Biofilmbildung. Flagellen tragen v. a. zur bakteriellen Aszension im Harnwegstrakt bei. Bakterielle Toxine können in späteren Infektionsstadien Wirtszellen zerstören. Extrazelluläre Polysaccharide, Kapseln und langkettiges O-Antigen schützen Bakterien vor dem Immunsystem des Wirts. Darüber hinaus können Uropathogene aber auch aktiv die mukosale Entzündungsreaktion inhibieren und verfügen über verschiedene Stoffwechseleigenschaften, die ihre Fitness und das Überleben im Harnwegstrakt fördern.
Abstract
In contrast to many commensal bacteria, uropathogens are equipped with many virulence-associated factors that facilitate infection of different areas of the urinary tract. Different extra- and intracellular bacterial lifestyles result in acute or recurrent urinary tract infection. Adhesins promote adhesion or invasion as well as biofilm formation. Flagella do not only allow ascension from the urethra to the bladder and even further to the kidneys, but can also function as adhesins and invasins. In later stages of an infection, toxins may destroy host cells, thus protecting against the host response or releasing nutrients. Extracellular polysaccharides, capsules, and the O-antigen protect bacteria against the host immune system. Furthermore, uropathogens may also directly inhibit the mucosal inflammatory response. Specific metabolic traits promote fitness, growth and survival in the urinary tract.
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Danksagung
Unsere eigenen Arbeiten zu diesem Thema wurden von der Deutschen Forschungsgemeinschaft (SFB 479), der Bayerischen Forschungsstiftung, dem Europäischen Exzellenznetzwerk „EuroPathoGenomics“ (CEE LSHB-CT-2005–512061) und dem ERA-NET PathoGenoMics (FKZ 0313937A) gefördert.
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Dobrindt, U. Virulenzfaktoren uropathogener Erreger. Urologe 49, 598–605 (2010). https://doi.org/10.1007/s00120-010-2251-6
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DOI: https://doi.org/10.1007/s00120-010-2251-6