Impact of polymicrobial biofilms in catheter-associated urinary tract infections

Abstract

Recent reports have demonstrated that most biofilms involved in catheter-associated urinary tract infections are polymicrobial communities, with pathogenic microorganisms (e.g. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and uncommon microorganisms (e.g. Delftia tsuruhatensis, Achromobacter xylosoxidans) frequently co-inhabiting the same urinary catheter. However, little is known about the interactions that occur between different microorganisms and how they impact biofilm formation and infection outcome. This lack of knowledge affects CAUTIs management as uncommon bacteria action can, for instance, influence the rate at which pathogens adhere and grow, as well as affect the overall biofilm resistance to antibiotics. Another relevant aspect is the understanding of factors that drive a single pathogenic bacterium to become prevalent in a polymicrobial community and subsequently cause infection. In this review, a general overview about the IMDs-associated biofilm infections is provided, with an emphasis on the pathophysiology and the microbiome composition of CAUTIs. Based on the available literature, it is clear that more research about the microbiome interaction, mechanisms of biofilm formation and of antimicrobial tolerance of the polymicrobial consortium are required to better understand and treat these infections.

Keywords:

• Catheter-associated urinary tract infections
• pathogenic bacteria
• uncommon bacteria
• microbiome
• microbial ecology

Acknowledgements

This work was financially supported by: Project POCI-01-0145-FEDER-006939 – Laboratory for Process Engineering, Environment, Biotechnology and Energy – LEPABE funded by FEDER funds through COMPETE2020 – Programa Operacional Competitividade e Internacionalização (POCI) – and by national funds through FCT – Fundacao para a Ciência e a Tecnologia; Project “DNAmimics” [PIC/IC/82815/2007]; PhD fellowships [SFRH/BD/82663/2011].

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This work was financially supported by: Project POCI-01-0145-FEDER-006939 – Laboratory for Process Engineering, Environment, Biotechnology and Energy – LEPABE funded by FEDER funds through COMPETE2020 – Programa Operacional Competitividade e Internacionalização (POCI) – and by national funds through FCT – Fundacao para a Ciência e a Tecnologia; Project “DNAmimics” [PIC/IC/82815/2007]; PhD fellowships [SFRH/BD/82663/2011].