Механизмы развития инфекции мочевых путей и бессимптомной бактериурии
Механизмы развития инфекции мочевых путей и бессимптомной бактериурии
Захарова И.Н., Мумладзе Э.Б., Мачнева Е.Б., Касьянова А.Н. Механизмы развития инфекции мочевых путей и бессимптомной бактериурии. Педиатрия (Прил. к журн. Consilium Medicum). 2018; 1: 106–110.
DOI: 10.26442/2413-8460_2018.1.106-110
DOI: 10.26442/2413-8460_2018.1.106-110
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Аннотация
В обзорной статье приводятся современные данные о процессах, происходящих на поверхности эпителия мочевых путей при взаимодействии с микроорганизмами. Описаны три основных звена, отвечающих за формирование бессимптомной бактериурии и инфекции мочевых путей – особенности микроорганизма, особенности иммунного ответа организма на присутствие микроба в мочевых путях, а также особенности воздействия микро- и макроорганизма друг на друга. Особое внимание уделено данным о нормальном микробиоме мочи и его протективных свойствах.
Ключевые слова: бессимптомная бактериурия, микробиом мочи, вирулентность, уропатогенные штаммы, инфекция мочевых путей, цистит, пиелонефрит, кишечная палочка.
Key words: asymptomatic bacteriuria, urine microbiology, virulence, uropathogenic strains, urinary tract infection, cystitis, pyelonephritis, E. coli.
Ключевые слова: бессимптомная бактериурия, микробиом мочи, вирулентность, уропатогенные штаммы, инфекция мочевых путей, цистит, пиелонефрит, кишечная палочка.
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Key words: asymptomatic bacteriuria, urine microbiology, virulence, uropathogenic strains, urinary tract infection, cystitis, pyelonephritis, E. coli.
Список литературы
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26. Hannan TJ, Mysorekar IU, Hung CS et al. Early severe inflammatory responses to uropathogenic E. coli predispose to chronic and recurrent urinary tract infection. PLoS Pathog 2010; 6 (8): e1001042.
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28. Ingersoll MA, Albert ML. From infection to immunotherapy: host immune responses to bacteria at the bladder mucosa. Mucosal Immunol 2013; 6 (6): 1041–53.
29. Fouts DE, Pieper R, Szpakowski S et al. Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 2012; 10: 174.
30. Siddiqui H, Nederbragt AJ, Lagesen K et al. Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol 2011; 11: 244.
31. Sundén F, Hаkansson L, Ljunggren E, Wullt B. Bacterial interference-is deliberate colonization with Escherichia coli 83972 an alternative treatment for patients with recurrent urinary tract infection? Int J Antimicrob Agents 2006; 28 (Suppl. 1): S26–9.
32. Darouiche RO, Hull RA. Bacterial interference for prevention of urinary tract infection. Clin Infect Dis 2012; 55: 1400–7.
33. Zdziarski J, Brzuszkiewicz E, Wullt B et al. Host Imprints on Bacterial Genomes-Rapid, Divergent Evolution in Individual Patients. PLoS Pathog 2010; 6 (8).
34. Naber KG, Kogan M, Wagenlehner FME et al. How the microbiome is influenced by the therapy of urological diseases: standard versus alternative approaches. Clin Phytoscience 2017; 3: 8.
35. Ivanov D, Abramov-Sommariva D, Moritz K et al. An open label, non-controlled, multicentre, interventional trial to investigate the safety and efficacy of Canephron® N in the management of uncomplicated urinary tract infections (uUTIs). Clin Phytoscience 2015; 1: 7.
36. Gessner A. The influence of urologic therapeutics on the microbiome in an experimental model” in “How the microbiome is influenced by the therapy of urological diseases: standard vs. alternative approaches”. Munich: 31st Annual EAU Congress; 2016.
2. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon 2003; 49 (2): 71–82.
3. Jones CH, Pinkner JS, Roth R et al. FimH adhesin of type 1 pili is assembled into a fibrillar tip structure in the Enterobacteriaceae. Proc Natl Acad Sci USA 1995; 92 (6): 2081–5.
4. Zhou G, Mo WJ, Sebbel P et al. Uroplakin Ia is the urothelial receptor for uropathogenic Escherichia coli: evidence from in vitro FimH binding. J Cell Sci 2001; 114 (Pt. 22): 4095–103.
5. Xie B, Zhou G, Chan SY et al. Distinct glycan structures of uroplakins Ia and Ib: structural basis for the selective binding of FimH adhesin to uroplakin Ia. J Biol Chem 2006; 281 (21): 14644–53.
6. Martinez JJ, Mulvey MA, Schilling JD et al. Type 1 pilus-mediated bacterial invasion of bladder epithelial cells. EMBO J 2000; 19 (12): 2803–12.
7. Rosen DA, Pinkner JS, Walker JN et al. Molecular variations in Klebsiella pneumoniae and Escherichia coli FimH affect function and pathogenesis in the urinary tract. Infect Immun 2008; 76 (7): 3346–56.
8. Martinez JJ, Mulvey MA, Schilling JD et al. Type 1 pilus-mediated bacterial invasion of bladder epithelial cells. EMBO J 2000; 19 (12): 2803–12.
9. Dhakal BK, Mulvey MA. Uropathogenic Escherichia coli invades host cells via an HDAC6-modulated microtubule-dependent pathway. J Biol Chem 2009; 284 (1): 446–54.
10. Justice SS, Hung C, Theriot JA et al. Differentiation and developmental pathways of uropathogenic Escherichia coli in urinary tract pathogenesis. Proc Natl Acad Sci USA 2004; 101 (5): 1333–8.
11. Rosen DA, Pinkner JS, Jones JM et al. Utilization of an intracellular bacterial community pathway in Klebsiella pneumoniae urinary tract infection and the effects of FimK on type 1 pilus expression. Infect Immun 2008; 76 (7): 3337–45.
12. Mysorekar IU, Hultgren SJ. Mechanisms of uropathogenic Escherichia coli persistence and eradication from the urinary tract. Proc Natl Acad Sci USA 2006; 103 (38): 14170–5.
13. Kau AL, Martin SM, Lyon W et al. Enterococcus faecalis tropism for the kidneys in the urinary tract of C57BL/6J mice. Infect Immun 2005; 73 (4): 2461–8.
14. Kline KA, Ingersoll MA, Nielsen HV et al. Characterization of a novel murine model of Staphylococcus saprophyticus urinary tract infection reveals roles for Ssp and SdrI in virulence. Infect Immun 2010; 78 (5): 1943–51.
15. Nielubowicz GR, Mobley HL. Host-pathogen interactions in urinary tract infection. Nat Rev Urol 2010; 7 (8): 430–41.
16. Sobel JD, Fisher JF, Kauffman CA, Newman CA. Candida urinary tract infections – epidemiology. Clin Infect Dis 2011; 52 (Suppl. 6): S433–6.
17. Tsai PW, Yang CY, Chang HT, Lan CY. Human antimicrobial peptide LL-37 inhibits adhesion of Candida albicans by interacting with yeast cell-wall carbohydrates. PLoS One 2011; 6 (3): e17755.
18. Yin X, Hou T, Liu Y et al. Association of Toll-like receptor 4 gene polymorphism and expression with urinary tract infection types in adults. PLoS One 2010; 5 (12): e14223.
19. Fischer H, Yamamoto M, Akira S et al. Mechanism of pathogen-specific TLR4 activation in the mucosa: fimbriae, recognition receptors and adaptor protein selection. Eur J Immunol 2006; 36 (2): 267–77.
20. Ragnarsdоttir B, Fischer H, Godaly G et al. TLR- and CXCR1-dependent innate immunity: insights into the genetics of urinary tract infections. Eur J Clin Invest 2008; 38 (Suppl. 2): 12–20.
21. Ragnarsdóttir B, Samuelsson M, Gustafsson MC et al. Reduced toll-like receptor 4 expression in children with asymptomatic bacteriuria. J Infect Dis 2007; 196 (3): 475–84.
22. Wang H, Min G, Glockshuber R et al. Uropathogenic E. coli adhesin-induced host cell receptor conformational changes: implications in transmembrane signaling transduction. J Mol Biol 2009; 392 (2): 352–61.
23. Klumpp DJ, Rycyk MT, Chen MC et al. Uropathogenic Escherichia coli induces extrinsic and intrinsic cascades to initiate urothelial apoptosis. Infect Immun 2006; 74 (9): 5106–13.
24. Ingersoll MA, Kline KA, Nielsen HV, Hultgren SJ. G-CSF induction early in uropathogenic Escherichia coli infection of the urinary tract modulates host immunity. Cell Microbiol 2008; 10 (12): 2568–78.
25. Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. Med Clin North Am 2011; 95 (1): 27–41.
26. Hannan TJ, Mysorekar IU, Hung CS et al. Early severe inflammatory responses to uropathogenic E. coli predispose to chronic and recurrent urinary tract infection. PLoS Pathog 2010; 6 (8): e1001042.
27. Sivick KE, Mobley HL. Waging war against uropathogenic Escherichia coli: winning back the urinary tract. Infect Immun 2010; 78 (2): 568–85.
28. Ingersoll MA, Albert ML. From infection to immunotherapy: host immune responses to bacteria at the bladder mucosa. Mucosal Immunol 2013; 6 (6): 1041–53.
29. Fouts DE, Pieper R, Szpakowski S et al. Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 2012; 10: 174.
30. Siddiqui H, Nederbragt AJ, Lagesen K et al. Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol 2011; 11: 244.
31. Sundén F, Hаkansson L, Ljunggren E, Wullt B. Bacterial interference-is deliberate colonization with Escherichia coli 83972 an alternative treatment for patients with recurrent urinary tract infection? Int J Antimicrob Agents 2006; 28 (Suppl. 1): S26–9.
32. Darouiche RO, Hull RA. Bacterial interference for prevention of urinary tract infection. Clin Infect Dis 2012; 55: 1400–7.
33. Zdziarski J, Brzuszkiewicz E, Wullt B et al. Host Imprints on Bacterial Genomes-Rapid, Divergent Evolution in Individual Patients. PLoS Pathog 2010; 6 (8).
34. Naber KG, Kogan M, Wagenlehner FME et al. How the microbiome is influenced by the therapy of urological diseases: standard versus alternative approaches. Clin Phytoscience 2017; 3: 8.
35. Ivanov D, Abramov-Sommariva D, Moritz K et al. An open label, non-controlled, multicentre, interventional trial to investigate the safety and efficacy of Canephron® N in the management of uncomplicated urinary tract infections (uUTIs). Clin Phytoscience 2015; 1: 7.
36. Gessner A. The influence of urologic therapeutics on the microbiome in an experimental model” in “How the microbiome is influenced by the therapy of urological diseases: standard vs. alternative approaches”. Munich: 31st Annual EAU Congress; 2016.
2. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon 2003; 49 (2): 71–82.
3. Jones CH, Pinkner JS, Roth R et al. FimH adhesin of type 1 pili is assembled into a fibrillar tip structure in the Enterobacteriaceae. Proc Natl Acad Sci USA 1995; 92 (6): 2081–5.
4. Zhou G, Mo WJ, Sebbel P et al. Uroplakin Ia is the urothelial receptor for uropathogenic Escherichia coli: evidence from in vitro FimH binding. J Cell Sci 2001; 114 (Pt. 22): 4095–103.
5. Xie B, Zhou G, Chan SY et al. Distinct glycan structures of uroplakins Ia and Ib: structural basis for the selective binding of FimH adhesin to uroplakin Ia. J Biol Chem 2006; 281 (21): 14644–53.
6. Martinez JJ, Mulvey MA, Schilling JD et al. Type 1 pilus-mediated bacterial invasion of bladder epithelial cells. EMBO J 2000; 19 (12): 2803–12.
7. Rosen DA, Pinkner JS, Walker JN et al. Molecular variations in Klebsiella pneumoniae and Escherichia coli FimH affect function and pathogenesis in the urinary tract. Infect Immun 2008; 76 (7): 3346–56.
8. Martinez JJ, Mulvey MA, Schilling JD et al. Type 1 pilus-mediated bacterial invasion of bladder epithelial cells. EMBO J 2000; 19 (12): 2803–12.
9. Dhakal BK, Mulvey MA. Uropathogenic Escherichia coli invades host cells via an HDAC6-modulated microtubule-dependent pathway. J Biol Chem 2009; 284 (1): 446–54.
10. Justice SS, Hung C, Theriot JA et al. Differentiation and developmental pathways of uropathogenic Escherichia coli in urinary tract pathogenesis. Proc Natl Acad Sci USA 2004; 101 (5): 1333–8.
11. Rosen DA, Pinkner JS, Jones JM et al. Utilization of an intracellular bacterial community pathway in Klebsiella pneumoniae urinary tract infection and the effects of FimK on type 1 pilus expression. Infect Immun 2008; 76 (7): 3337–45.
12. Mysorekar IU, Hultgren SJ. Mechanisms of uropathogenic Escherichia coli persistence and eradication from the urinary tract. Proc Natl Acad Sci USA 2006; 103 (38): 14170–5.
13. Kau AL, Martin SM, Lyon W et al. Enterococcus faecalis tropism for the kidneys in the urinary tract of C57BL/6J mice. Infect Immun 2005; 73 (4): 2461–8.
14. Kline KA, Ingersoll MA, Nielsen HV et al. Characterization of a novel murine model of Staphylococcus saprophyticus urinary tract infection reveals roles for Ssp and SdrI in virulence. Infect Immun 2010; 78 (5): 1943–51.
15. Nielubowicz GR, Mobley HL. Host-pathogen interactions in urinary tract infection. Nat Rev Urol 2010; 7 (8): 430–41.
16. Sobel JD, Fisher JF, Kauffman CA, Newman CA. Candida urinary tract infections – epidemiology. Clin Infect Dis 2011; 52 (Suppl. 6): S433–6.
17. Tsai PW, Yang CY, Chang HT, Lan CY. Human antimicrobial peptide LL-37 inhibits adhesion of Candida albicans by interacting with yeast cell-wall carbohydrates. PLoS One 2011; 6 (3): e17755.
18. Yin X, Hou T, Liu Y et al. Association of Toll-like receptor 4 gene polymorphism and expression with urinary tract infection types in adults. PLoS One 2010; 5 (12): e14223.
19. Fischer H, Yamamoto M, Akira S et al. Mechanism of pathogen-specific TLR4 activation in the mucosa: fimbriae, recognition receptors and adaptor protein selection. Eur J Immunol 2006; 36 (2): 267–77.
20. Ragnarsdоttir B, Fischer H, Godaly G et al. TLR- and CXCR1-dependent innate immunity: insights into the genetics of urinary tract infections. Eur J Clin Invest 2008; 38 (Suppl. 2): 12–20.
21. Ragnarsdóttir B, Samuelsson M, Gustafsson MC et al. Reduced toll-like receptor 4 expression in children with asymptomatic bacteriuria. J Infect Dis 2007; 196 (3): 475–84.
22. Wang H, Min G, Glockshuber R et al. Uropathogenic E. coli adhesin-induced host cell receptor conformational changes: implications in transmembrane signaling transduction. J Mol Biol 2009; 392 (2): 352–61.
23. Klumpp DJ, Rycyk MT, Chen MC et al. Uropathogenic Escherichia coli induces extrinsic and intrinsic cascades to initiate urothelial apoptosis. Infect Immun 2006; 74 (9): 5106–13.
24. Ingersoll MA, Kline KA, Nielsen HV, Hultgren SJ. G-CSF induction early in uropathogenic Escherichia coli infection of the urinary tract modulates host immunity. Cell Microbiol 2008; 10 (12): 2568–78.
25. Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. Med Clin North Am 2011; 95 (1): 27–41.
26. Hannan TJ, Mysorekar IU, Hung CS et al. Early severe inflammatory responses to uropathogenic E. coli predispose to chronic and recurrent urinary tract infection. PLoS Pathog 2010; 6 (8): e1001042.
27. Sivick KE, Mobley HL. Waging war against uropathogenic Escherichia coli: winning back the urinary tract. Infect Immun 2010; 78 (2): 568–85.
28. Ingersoll MA, Albert ML. From infection to immunotherapy: host immune responses to bacteria at the bladder mucosa. Mucosal Immunol 2013; 6 (6): 1041–53.
29. Fouts DE, Pieper R, Szpakowski S et al. Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 2012; 10: 174.
30. Siddiqui H, Nederbragt AJ, Lagesen K et al. Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol 2011; 11: 244.
31. Sundén F, Hаkansson L, Ljunggren E, Wullt B. Bacterial interference-is deliberate colonization with Escherichia coli 83972 an alternative treatment for patients with recurrent urinary tract infection? Int J Antimicrob Agents 2006; 28 (Suppl. 1): S26–9.
32. Darouiche RO, Hull RA. Bacterial interference for prevention of urinary tract infection. Clin Infect Dis 2012; 55: 1400–7.
33. Zdziarski J, Brzuszkiewicz E, Wullt B et al. Host Imprints on Bacterial Genomes-Rapid, Divergent Evolution in Individual Patients. PLoS Pathog 2010; 6 (8).
34. Naber KG, Kogan M, Wagenlehner FME et al. How the microbiome is influenced by the therapy of urological diseases: standard versus alternative approaches. Clin Phytoscience 2017; 3: 8.
35. Ivanov D, Abramov-Sommariva D, Moritz K et al. An open label, non-controlled, multicentre, interventional trial to investigate the safety and efficacy of Canephron® N in the management of uncomplicated urinary tract infections (uUTIs). Clin Phytoscience 2015; 1: 7.
36. Gessner A. The influence of urologic therapeutics on the microbiome in an experimental model” in “How the microbiome is influenced by the therapy of urological diseases: standard vs. alternative approaches”. Munich: 31st Annual EAU Congress; 2016.
________________________________________________
2. Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon 2003; 49 (2): 71–82.
3. Jones CH, Pinkner JS, Roth R et al. FimH adhesin of type 1 pili is assembled into a fibrillar tip structure in the Enterobacteriaceae. Proc Natl Acad Sci USA 1995; 92 (6): 2081–5.
4. Zhou G, Mo WJ, Sebbel P et al. Uroplakin Ia is the urothelial receptor for uropathogenic Escherichia coli: evidence from in vitro FimH binding. J Cell Sci 2001; 114 (Pt. 22): 4095–103.
5. Xie B, Zhou G, Chan SY et al. Distinct glycan structures of uroplakins Ia and Ib: structural basis for the selective binding of FimH adhesin to uroplakin Ia. J Biol Chem 2006; 281 (21): 14644–53.
6. Martinez JJ, Mulvey MA, Schilling JD et al. Type 1 pilus-mediated bacterial invasion of bladder epithelial cells. EMBO J 2000; 19 (12): 2803–12.
7. Rosen DA, Pinkner JS, Walker JN et al. Molecular variations in Klebsiella pneumoniae and Escherichia coli FimH affect function and pathogenesis in the urinary tract. Infect Immun 2008; 76 (7): 3346–56.
8. Martinez JJ, Mulvey MA, Schilling JD et al. Type 1 pilus-mediated bacterial invasion of bladder epithelial cells. EMBO J 2000; 19 (12): 2803–12.
9. Dhakal BK, Mulvey MA. Uropathogenic Escherichia coli invades host cells via an HDAC6-modulated microtubule-dependent pathway. J Biol Chem 2009; 284 (1): 446–54.
10. Justice SS, Hung C, Theriot JA et al. Differentiation and developmental pathways of uropathogenic Escherichia coli in urinary tract pathogenesis. Proc Natl Acad Sci USA 2004; 101 (5): 1333–8.
11. Rosen DA, Pinkner JS, Jones JM et al. Utilization of an intracellular bacterial community pathway in Klebsiella pneumoniae urinary tract infection and the effects of FimK on type 1 pilus expression. Infect Immun 2008; 76 (7): 3337–45.
12. Mysorekar IU, Hultgren SJ. Mechanisms of uropathogenic Escherichia coli persistence and eradication from the urinary tract. Proc Natl Acad Sci USA 2006; 103 (38): 14170–5.
13. Kau AL, Martin SM, Lyon W et al. Enterococcus faecalis tropism for the kidneys in the urinary tract of C57BL/6J mice. Infect Immun 2005; 73 (4): 2461–8.
14. Kline KA, Ingersoll MA, Nielsen HV et al. Characterization of a novel murine model of Staphylococcus saprophyticus urinary tract infection reveals roles for Ssp and SdrI in virulence. Infect Immun 2010; 78 (5): 1943–51.
15. Nielubowicz GR, Mobley HL. Host-pathogen interactions in urinary tract infection. Nat Rev Urol 2010; 7 (8): 430–41.
16. Sobel JD, Fisher JF, Kauffman CA, Newman CA. Candida urinary tract infections – epidemiology. Clin Infect Dis 2011; 52 (Suppl. 6): S433–6.
17. Tsai PW, Yang CY, Chang HT, Lan CY. Human antimicrobial peptide LL-37 inhibits adhesion of Candida albicans by interacting with yeast cell-wall carbohydrates. PLoS One 2011; 6 (3): e17755.
18. Yin X, Hou T, Liu Y et al. Association of Toll-like receptor 4 gene polymorphism and expression with urinary tract infection types in adults. PLoS One 2010; 5 (12): e14223.
19. Fischer H, Yamamoto M, Akira S et al. Mechanism of pathogen-specific TLR4 activation in the mucosa: fimbriae, recognition receptors and adaptor protein selection. Eur J Immunol 2006; 36 (2): 267–77.
20. Ragnarsdоttir B, Fischer H, Godaly G et al. TLR- and CXCR1-dependent innate immunity: insights into the genetics of urinary tract infections. Eur J Clin Invest 2008; 38 (Suppl. 2): 12–20.
21. Ragnarsdóttir B, Samuelsson M, Gustafsson MC et al. Reduced toll-like receptor 4 expression in children with asymptomatic bacteriuria. J Infect Dis 2007; 196 (3): 475–84.
22. Wang H, Min G, Glockshuber R et al. Uropathogenic E. coli adhesin-induced host cell receptor conformational changes: implications in transmembrane signaling transduction. J Mol Biol 2009; 392 (2): 352–61.
23. Klumpp DJ, Rycyk MT, Chen MC et al. Uropathogenic Escherichia coli induces extrinsic and intrinsic cascades to initiate urothelial apoptosis. Infect Immun 2006; 74 (9): 5106–13.
24. Ingersoll MA, Kline KA, Nielsen HV, Hultgren SJ. G-CSF induction early in uropathogenic Escherichia coli infection of the urinary tract modulates host immunity. Cell Microbiol 2008; 10 (12): 2568–78.
25. Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. Med Clin North Am 2011; 95 (1): 27–41.
26. Hannan TJ, Mysorekar IU, Hung CS et al. Early severe inflammatory responses to uropathogenic E. coli predispose to chronic and recurrent urinary tract infection. PLoS Pathog 2010; 6 (8): e1001042.
27. Sivick KE, Mobley HL. Waging war against uropathogenic Escherichia coli: winning back the urinary tract. Infect Immun 2010; 78 (2): 568–85.
28. Ingersoll MA, Albert ML. From infection to immunotherapy: host immune responses to bacteria at the bladder mucosa. Mucosal Immunol 2013; 6 (6): 1041–53.
29. Fouts DE, Pieper R, Szpakowski S et al. Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 2012; 10: 174.
30. Siddiqui H, Nederbragt AJ, Lagesen K et al. Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol 2011; 11: 244.
31. Sundén F, Hаkansson L, Ljunggren E, Wullt B. Bacterial interference-is deliberate colonization with Escherichia coli 83972 an alternative treatment for patients with recurrent urinary tract infection? Int J Antimicrob Agents 2006; 28 (Suppl. 1): S26–9.
32. Darouiche RO, Hull RA. Bacterial interference for prevention of urinary tract infection. Clin Infect Dis 2012; 55: 1400–7.
33. Zdziarski J, Brzuszkiewicz E, Wullt B et al. Host Imprints on Bacterial Genomes-Rapid, Divergent Evolution in Individual Patients. PLoS Pathog 2010; 6 (8).
34. Naber KG, Kogan M, Wagenlehner FME et al. How the microbiome is influenced by the therapy of urological diseases: standard versus alternative approaches. Clin Phytoscience 2017; 3: 8.
35. Ivanov D, Abramov-Sommariva D, Moritz K et al. An open label, non-controlled, multicentre, interventional trial to investigate the safety and efficacy of Canephron® N in the management of uncomplicated urinary tract infections (uUTIs). Clin Phytoscience 2015; 1: 7.
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Авторы
И.Н.Захарова*, Э.Б.Мумладзе, Е.Б.Мачнева, А.Н.Касьянова
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
*zakharova-rmapo@yandex.ru
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125995, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*zakharova-rmapo@yandex.ru
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
*zakharova-rmapo@yandex.ru
________________________________________________
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125995, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*zakharova-rmapo@yandex.ru
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