Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.

Bacterial urinary tract infections (UTI) are a major growing concern worldwide. Uropathogenic Escherichia coli has been shown to invade the urothelium during acute UTI in mice and humans, forming intracellular reservoirs that can evade antibiotics and the immune response, allowing recurrence at a la...

Full description

Bibliographic Details
Main Authors: Harry Horsley, James Malone-Lee, David Holland, Madeleine Tuz, Andrew Hibbert, Michael Kelsey, Anthony Kupelian, Jennifer L Rohn
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3868479?pdf=render
_version_ 1818172322366881792
author Harry Horsley
James Malone-Lee
David Holland
Madeleine Tuz
Andrew Hibbert
Michael Kelsey
Anthony Kupelian
Jennifer L Rohn
author_facet Harry Horsley
James Malone-Lee
David Holland
Madeleine Tuz
Andrew Hibbert
Michael Kelsey
Anthony Kupelian
Jennifer L Rohn
author_sort Harry Horsley
collection DOAJ
description Bacterial urinary tract infections (UTI) are a major growing concern worldwide. Uropathogenic Escherichia coli has been shown to invade the urothelium during acute UTI in mice and humans, forming intracellular reservoirs that can evade antibiotics and the immune response, allowing recurrence at a later date. Other bacterial species, such as Staphylococcus saprophyticus, Klebsiella pneumonia and Salmonella enterica have also been shown to be invasive in acute UTI. However, the role of intracellular infection in chronic UTI causing more subtle lower urinary tract symptoms (LUTS), a particular problem in the elderly population, is poorly understood. Moreover, the species of bacteria involved remains largely unknown. A previous study of a large cohort of non-acute LUTS patients found that Enterococcus faecalis was frequently found in urine specimens. E. faecalis accounts for a significant proportion of chronic bladder infections worldwide, although the invasive lifestyle of this uropathogen has yet to be reported. Here, we wanted to explore this question in more detail. We harvested urothelial cells shed in response to inflammation and, using advanced imaging techniques, inspected them for signs of bacterial pathology and invasion. We found strong evidence of intracellular E. faecalis harboured within urothelial cells shed from the bladder of LUTS patients. Furthermore, using a culture model system, these patient-isolated strains of E. faecalis were able to invade a transitional carcinoma cell line. In contrast, we found no evidence of cellular invasion by E. coli in the patient cells or the culture model system. Our data show that E. faecalis is highly competent to invade in this context; therefore, these results have implications for both the diagnosis and treatment of chronic LUTS.
first_indexed 2024-12-11T19:10:46Z
format Article
id doaj.art-d9f5f4673636435e88e399f973e73a3c
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-11T19:10:46Z
publishDate 2013-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-d9f5f4673636435e88e399f973e73a3c2022-12-22T00:53:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01812e8363710.1371/journal.pone.0083637Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.Harry HorsleyJames Malone-LeeDavid HollandMadeleine TuzAndrew HibbertMichael KelseyAnthony KupelianJennifer L RohnBacterial urinary tract infections (UTI) are a major growing concern worldwide. Uropathogenic Escherichia coli has been shown to invade the urothelium during acute UTI in mice and humans, forming intracellular reservoirs that can evade antibiotics and the immune response, allowing recurrence at a later date. Other bacterial species, such as Staphylococcus saprophyticus, Klebsiella pneumonia and Salmonella enterica have also been shown to be invasive in acute UTI. However, the role of intracellular infection in chronic UTI causing more subtle lower urinary tract symptoms (LUTS), a particular problem in the elderly population, is poorly understood. Moreover, the species of bacteria involved remains largely unknown. A previous study of a large cohort of non-acute LUTS patients found that Enterococcus faecalis was frequently found in urine specimens. E. faecalis accounts for a significant proportion of chronic bladder infections worldwide, although the invasive lifestyle of this uropathogen has yet to be reported. Here, we wanted to explore this question in more detail. We harvested urothelial cells shed in response to inflammation and, using advanced imaging techniques, inspected them for signs of bacterial pathology and invasion. We found strong evidence of intracellular E. faecalis harboured within urothelial cells shed from the bladder of LUTS patients. Furthermore, using a culture model system, these patient-isolated strains of E. faecalis were able to invade a transitional carcinoma cell line. In contrast, we found no evidence of cellular invasion by E. coli in the patient cells or the culture model system. Our data show that E. faecalis is highly competent to invade in this context; therefore, these results have implications for both the diagnosis and treatment of chronic LUTS.http://europepmc.org/articles/PMC3868479?pdf=render
spellingShingle Harry Horsley
James Malone-Lee
David Holland
Madeleine Tuz
Andrew Hibbert
Michael Kelsey
Anthony Kupelian
Jennifer L Rohn
Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.
PLoS ONE
title Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.
title_full Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.
title_fullStr Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.
title_full_unstemmed Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.
title_short Enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection.
title_sort enterococcus faecalis subverts and invades the host urothelium in patients with chronic urinary tract infection
url http://europepmc.org/articles/PMC3868479?pdf=render
work_keys_str_mv AT harryhorsley enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection
AT jamesmalonelee enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection
AT davidholland enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection
AT madeleinetuz enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection
AT andrewhibbert enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection
AT michaelkelsey enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection
AT anthonykupelian enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection
AT jenniferlrohn enterococcusfaecalissubvertsandinvadesthehosturotheliuminpatientswithchronicurinarytractinfection