The Role of Escherichia coli Autotransporters in Urinary Tract Infections and Urosepsis.

Urinary tract infections (UTIs) caused by Uropathogenic Escherichia coli (UPEC) strains are among the most common bacterial infections in humans, causing cystitis, pyelonephritis and, in the absence of appropriate treatment, sepsis. Effective therapies and preventive strategies are still lacking, which highlights the need to better understand UPEC virulence mechanisms. Herein, we describe the role of three groups of bacterial autotransporters (ATs): serine protease autotransporter (SPATE), trimeric autotransporter adhesins (TAA), and autotransporter adhesin AIDA-I, and their possible contribution to the induction of UTI and urosepsis. AT, depending on the type, exhibits functions such as adhesion, serum resistance, hemagglutination, protease activity, biofilm formation and toxin activity. By summarizing the molecular functions of AT proteins, our review highlights their potential as targets for novel therapeutic and preventive approaches against UTIs and urosepsis.