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Aptitude of Uropathogenic Escherichia coli in Renal Transplant Recipients: A Comprehensive Review on Characteristic Features, and Production of Extended Spectrum β-Lactamase

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Abstract

Urinary tract infection is the most common infection in almost half of the renal transplant patients. The development of UTI in these patients may progress to bacteremia, acute T cell-mediated rejection, impaired allograft function, or allograft loss, along with the increased risk of hospitalization and death. Among various pathogens implicated, Uropathogenic E. coli (UPEC), especially sequence type 131 (ST131), is the most virulent and multidrug-resistant pathogen. High antimicrobial resistance to most β-lactam antibiotics, mediated by extended spectrum β-lactamases (ESBLs) produced by UPEC, is a challenge in the clinical management of UTIs in kidney transplant recipients. Indeed, multidrug resistance to β-lactam antibiotics is a direct consequence of ESBL production. Resistance to other antibiotics such as aminoglycosides, fluoroquinolones, and trimethoprim-sulphamethoxazole has also been reported in ESBLs-producing UPEC, which reduces the therapeutic options, rising healthcare-associated costs and subsequently leads to renal failure or even graft loss. In this review, we aimed to discuss the post-transplant risk factors of UTI, UPEC virulence factors (VF), and the related factors including quorum sensing, and stress resistance genes. Furthermore, we searched for the current treatment strategies and some of the alternate approaches proposed as therapeutic options that may affirm the treatment of ESBL-producing UPEC.

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All authors have made substantial contributions. All authors have approved the final article and have contributed sufficiently to the project to be included as authors.

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Acknowledgements

We thank staff of Clinical Research Development Unit, Sina Educational, Research and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran for their meticulous support.

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Authors and Affiliations

  1. Clinical Research Development Unit, Sina Educational, Research and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Masoomeh Kashef Nejad, Alka Hasani, Saiedeh Razi Soofiyani & Maryam Zaare Nahandi

  2. Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Alka Hasani

  3. Department of Molecular Medicine, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran

    Saiedeh Razi Soofiyani

  4. Department of Clinical Biochemistry and Laboratory Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Akbar Hasani

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  1. Masoomeh Kashef Nejad
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  2. Alka Hasani
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  3. Saiedeh Razi Soofiyani
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  4. Maryam Zaare Nahandi
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Contributions

Conception of the article: MKN and AH. Literature search: MKN, AH and SRS. Data analysis: MKN, AH, MZN and AH. Draft revision of the work: AH and MKN.

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Correspondence to Alka Hasani.

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Nejad, M.K., Hasani, A., Soofiyani, S.R. et al. Aptitude of Uropathogenic Escherichia coli in Renal Transplant Recipients: A Comprehensive Review on Characteristic Features, and Production of Extended Spectrum β-Lactamase. Curr Microbiol 80, 382 (2023). https://doi.org/10.1007/s00284-023-03476-w

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