Urinary Tract Infection: Different Therapeutic Strategies

Background and Aim : Urinary tract infections (UTIs) are among the most common microbialinfections in humans and represent a substantial burden on the health care system. UropathogenicEscherichia coli (UPEC) strains are the most prevalent causative agent of UTIs. Other bacteria likeproteus mirabilis, klebsiella pneumonia are among causative agent. The routine therapy of UTIs isbased on the use of antibiotics such as β-lactams, trimethoprim, nitrofurantoin and quinolones inmany countries. Increasing antibiotic resistance and their side effects on human body show theneed to develop alternative strategies such as vaccine against UTIs. Different vaccines based onthe whole cells (killed or live-attenuated vaccines) and antigens (subunits, toxins and conjugatedvaccines) have been evaluated against UTIs pathogens. Furthermore, other therapeutic strategiessuch as the use of probiotics and antimicrobial peptides are considered against UTIs.Methods : We in our group for more than a decade focused our research on different strategies forUTI treatment. Multi-epitope vaccines using insilico studies, based on epitope mapping ofdifferent virulence factors, using various adjuvants, other strategies, using Lactobacillus bacteria(LAB) as probiotic expressing virulence factors, were used. Anti-Sense Oligonucelotides (ASO)to inhibit target genes were also examined.Results : Although all these attempts resulted in desirable humoral and cellular immune responsesor inhibited target genes respectively; however, due to lack of suitable animal model are still inexperimental phase. Among latest attempts we focused on use of Anti-microbial peptides (AMPs)that inhibit the biofilm formation in combination with antibiotics, which seems have promisingprospective as alternative therapeutic strategy.Conclusion : In conclusion based on our findings it seems that if vaccines should be developedfor the treatment it should be made based on prevalent serotypes circulating in the country.Moreover, search for more AMPs with antibiofilm ability in combination with antibiotics to beused for treatment is other way to tackle the disease.

کلیدواژه ها:

UTI ، virulence factors ، vaccines ، AMPs