Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Enterococcus faecalis Polymicrobial Interactions Facilitate Biofilm Formation, Antibiotic Recalcitrance, and Persistent Colonization of the Catheterized Urinary Tract

Version 1 : Received: 30 September 2020 / Approved: 30 September 2020 / Online: 30 September 2020 (16:39:51 CEST)

A peer-reviewed article of this Preprint also exists.

Gaston, J.R.; Andersen, M.J.; Johnson, A.O.; Bair, K.L.; Sullivan, C.M.; Guterman, L.B.; White, A.N.; Brauer, A.L.; Learman, B.S.; Flores-Mireles, A.L.; Armbruster, C.E. Enterococcus faecalis Polymicrobial Interactions Facilitate Biofilm Formation, Antibiotic Recalcitrance, and Persistent Colonization of the Catheterized Urinary Tract. Pathogens 2020, 9, 835. Gaston, J.R.; Andersen, M.J.; Johnson, A.O.; Bair, K.L.; Sullivan, C.M.; Guterman, L.B.; White, A.N.; Brauer, A.L.; Learman, B.S.; Flores-Mireles, A.L.; Armbruster, C.E. Enterococcus faecalis Polymicrobial Interactions Facilitate Biofilm Formation, Antibiotic Recalcitrance, and Persistent Colonization of the Catheterized Urinary Tract. Pathogens 2020, 9, 835.

Journal reference: Pathogens 2020, 9, 835
DOI: 10.3390/pathogens9100835

Abstract

Indwelling urinary catheters are common in healthcare settings and can lead to catheter-associated urinary tract infection (CAUTI). Long-term catheterization causes polymicrobial colonization of the catheter and urine, for which the clinical significance is poorly understood. Through prospective assessment of catheter urine colonization, we identified Enterococcus faecalis and Proteus mirabilis as the most prevalent and persistent co-colonizers. Clinical isolates of both species successfully co-colonized in a murine model of CAUTI, and they were observed to co-localize on catheter biofilms during infection. We further demonstrate that P. mirabilis preferentially adheres to E. faecalis during biofilm formation, and that contact-dependent interactions between E. faecalis and P. mirabilis facilitate establishment of a robust biofilm architecture that enhances antimicrobial resistance for both species. E. faecalis may therefore act as a pioneer species on urinary catheters, establishing an ideal surface for persistent colonization by more traditional pathogens such as P. mirabilis.

Subject Areas

Enterococcus faecalis; Proteus mirabilis; Polymicrobial; Biofilm; Catheter; Urinary Tract Infection

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