New Strategies for the Prevention of Urinary Tract Infections by Uropathogenic Escherichia coli

Uropathogenic Escherichia coli (UPEC) is the leading causal agent of urinary tract infections (UTIs), which present high morbidity and limitations in antibiotic treatments. UTIs can also manifest as recurrent (RUTIs) in children and adults and represent a severe public health problem, mainly because there are no treatment and control alternatives that are 100% effective. Patients with RUTIs have a decreased quality of life and are prone to significant complications of UTIs, such as pyelonephritis and urosepsis. Recently, we described UPEC clinical strains related to UTI that have a high profile of antibiotic resistance [multidrug-resistant (MDR) and extensively drug-resistant (XDR)] and genes encoding several fimbrial adhesins, such as FimH of type 1 fimbriae, PapG of fimbriae P, and CsgA of Curli fimbriae. Recently, the expression of fimbrial adhesins (FimH, CsgA, and PapG) was shown to be involved in the release of the interleukins (IL) 6 and IL-8 in vitro. This work aims to present a broad overview and description of the pathogenic attributes of UPEC, including the infection processes, pathogenicity mechanisms, and host immune responses, as well as an integral perspective to generate new studies that would contribute to the implementation of preventive strategies against UTI.