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“E. coli uropatógeno” ha sido el término utilizado para describir las cepas de Escherichia coli capaces de causar infección urinaria (IU). Su caracterización a nivel molecular ha demostrado que son las mismas que causan infección en localizaciones extraintestinales no-urinarias, y se propone la designación más inclusiva de “E. coli patógeno extraintestinal” o ExPEC. Los ExPEC derivan principalmente del grupo filogenético B2 y albergan genes que codifican factores de virulencia, como fimH, papA, papG alelo II, kspM II, hlyA, cnf1, fyuA, iutA o traT, agrupados en islas de patogenicidad o PAI. El ecosistema vaginal, y en especial Lactobacillus, así como las poblaciones intestinales de E. coli, el coito y las condiciones fisiológicas y anatómicas del tracto urinario, desempeñan también un papel importante en la patogenia de la IU. La persistencia de E. coli en las biopelículas o pods vesicales o en el reservorio fecal podría explicar las infecciones recurrentes en mujeres jóvenes.
Palabras clave:
Infección urinaria
Patogenia
Escherichia coli
Factores de virulencia
Adhesinas
“Uropathogenic Escherichia coli” has been the term used to describe E. coli strains able to cause urinary tract infections. Their molecular characterization has demonstrated that these strains are the same as those causing infections in non-urinary extaintestinal locations, and it has been proposed thus the more inclusive term “extraintestinal pathogenic E. coli” or “ExPEC” to use. ExPEC derive mainly from the phylogenetic B2 group and harbor genes that codify virulence, such as fimH, papA, papG allele II, kspM II, hlyA, cnf1, fyuA, iutA, and traT, which are grouped in pathogenicity islands (PAIs). The vaginal ecosystem and especially Lactobacillus, as well as intestinal populations of E. coli, coitus and the physiological and anatomical conditions of the urinary tract also play a major role in the pathogenesis of urinary tract infections. The persistence of E. coli in bladder “biofilms” or “pods” or in the fecal reservoir could explain recurrent infections in young women.
Key words:
Urinary infection
Pathogenesis
Escherichia coli
Virulence factors
Adhesins
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