Impact of polymicrobial biofilms in catheter-associated urinary tract infections

Abstract

infections are polymicrobial communities, with pathogenic microorganisms (e.g. Escherichia coli,Pseudomonas aeruginosa, Klebsiella pneumoniae) and uncommon microorganisms (e.g. Delftia tsuruhatensis, Achromobacter xylosoxidans) frequently co-inhabiting the same urinary catheter.However, little is known about the interactions that occur between different microorganisms andhow they impact biofilm formation and infection outcome. This lack of knowledge affects CAUTIsmanagement as uncommon bacteria action can, for instance, influence the rate at which pathogens adhere and grow, as well as affect the overall biofilm resistance to antibiotics. Another relevant aspect is the understanding of factors that drive a single pathogenic bacterium to becomeprevalent in a polymicrobial community and subsequently cause infection. In this review, a general overview about the IMDs-associated biofilm infections is provided, with an emphasis on thepathophysiology and the microbiome composition of CAUTIs. Based on the available literature, itis clear that more research about the microbiome interaction, mechanisms of biofilm formationand of antimicrobial tolerance of the polymicrobial consortium are required to better understandand treat these infections.