Increased Age, but Not Parity Predisposes to Higher Bacteriuria Burdens Due to Streptococcus Urinary Tract Infection and Influences Bladder Cytokine Responses, Which Develop Independent of Tissue Bacterial Loads

PLoS One. 2016 Dec 9;11(12):e0167732. doi: 10.1371/journal.pone.0167732. eCollection 2016.

Abstract

Streptococcus agalactiae causes urinary tract infection (UTI) in pregnant adults, non-pregnant adults, immune-compromised individuals and the elderly. The pathogenesis of S. agalactiae UTI in distinct patient populations is poorly understood. In this study, we used murine models of UTI incorporating young mice, aged and dam mice to show that uropathogenic S. agalactiae causes bacteriuria at significantly higher levels in aged mice compared to young mice and this occurs coincident with equivalent levels of bladder tissue colonisation at 24 h post-infection (p.i.). In addition, aged mice exhibited significantly higher bacteriuria burdens at 48 h compared to young mice, confirming a divergent pattern of bacterial colonization in the urinary tract of aged and young mice. Multiparous mice, in contrast, exhibited significantly lower urinary titres of S. agalactiae compared to age-matched nulliparous mice suggesting that parity enhances the ability of the host to control S. agalactiae bacteriuria. Additionally, we show that both age and parity alter the expression levels of several key regulatory and pro-inflammatory cytokines, which are known to be important the immune response to UTI, including Interleukin (IL)-1β, IL-12(p40), and Monocyte Chemoattractant Protein-1 (MCP-1). Finally, we demonstrate that other cytokines, including IL-17 are induced significantly in the S. agalactiae-infected bladder regardless of age and parity status. Collectively, these findings show that the host environment plays an important role in influencing the severity of S. agalactiae UTI; infection dynamics, particularly in the context of bacteriuria, depend on age and parity, which also affect the nature of innate immune responses to infection.

MeSH terms

  • Age Factors
  • Animals
  • Bacterial Load
  • Bacteriuria / epidemiology*
  • Bacteriuria / immunology
  • Bacteriuria / microbiology
  • Bacteriuria / pathology
  • Cytokines / analysis
  • Cytokines / immunology
  • Female
  • Humans
  • Mice
  • Mice, Inbred C57BL
  • Parity*
  • Pregnancy
  • Streptococcal Infections / epidemiology*
  • Streptococcal Infections / immunology
  • Streptococcal Infections / microbiology
  • Streptococcal Infections / pathology
  • Streptococcus agalactiae / immunology
  • Streptococcus agalactiae / isolation & purification*
  • Urinary Bladder / immunology
  • Urinary Bladder / microbiology*
  • Urinary Bladder / pathology
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / immunology
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / pathology

Substances

  • Cytokines

Grants and funding

This work was supported by National Health and Medical Research Council (NHMRC) Project Grants (APP1005315) and funding from the Griffith Health Institute, and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)-Brazil (248427/2013-0 to SYL). AJC is supported by a NHMRC Early Career Peter Doherty Fellowship (APP1052464). GCU is supported by a Australian Research Council Future Fellowship (FT110101048). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.