Uropathogenic Escherichia coli Virulence and Antibiotic Resistance

Urinary tract infections (UTIs) are among the most common infectious diseases worldwide, causing chronic and recurrent issues that significantly impact work efficiency, personal responsibilities, quality of life, and sexual health. UTIs represent an exceedingly common condition affecting individuals of all ages and genders. Women exhibit a higher prevalence of UTIs compared to men, influenced by various clinical factors such as anatomical disparities, and hormonal effects. Escherichia coli (E. coli), typically intestinal flora, can thrive in the urinary system, leveraging virulence factors such as type 1-fimbriae, P fimbriae, S fimbriae, and alpha-hemolysin (HlyA) for invasion, colonization, and evasion of host defenses. A major healthcare concern is the increasing antibiotic resistance, particularly due to extended-spectrum beta-lactamases (ESBLs) like TEM, SHV, and CTX-M, which degrade beta-lactam antibiotics but can be inhibited by clavulanic acid, tazobactam, or sulbactam. OXA β-lactamases add to this resistance, especially against oxacillin and penicillin. The emergence of carbapenem-resistant Enterobacteriaceae, resistant to nearly all β-lactam antibiotics, further complicates treatment.