Infection urinaire | EPFL Graph Search

Une infection urinaire (ou infection des voies urinaires ou IVU) est définie par la colonisation des urines par des bactéries, ce qui se traduit le plus souvent par des signes infectieux urinaires. Elles sont très fréquentes, en particulier chez les nourrissons et les jeunes enfants, les femmes enceintes. Il existe deux tableaux principaux d'infection urinaire : la cystite (infection de la vessie) et la pyélonéphrite aiguë (infection du rein, PNA). Elles se traitent très bien par antibiotiques. L'insuffisance ou l'absence de traitement de la pyélonéphrite peut mener à des complications sévères . Les infections urinaires sont les infections bactériennes les plus fréquentes quel que soit l'âge. Entre 20 et 50 ans, les infections sont 50 fois plus fréquentes chez la femme, mais après 50 ans l’incidence chez l’homme augmente nettement du fait de l’augmentation des maladies prostatiques, et le ratio est donc seulement 3/1 chez les sujets âgés. L'infection urinaire chez l'homme a pratiq

Statistical Analysis of Chao’s Immune System Simulation

Eric Winnington

Modeling the immune system (IS) means putting together a set of assumptions about its components (cells and organs) and their interactions. Simulations of a model show joint behavior of the components, which for complex realistic models is often impossible to find analytically. Simulations allow us to experiment on how initial concentrations and properties of the immune cells and viruses impact the IS behavior, and gain better quantitative and qualitative insight into how the IS works and why different behavior patterns occur. A simulation, once it has been created, must be reviewed both statistically and analytically as well as validated from the biological point of view. We analyzed Chao’s immune system simulation [1][2] from a statistical and analytical point. We explicited both the Markov chain which was simulated and the underlying process on which Chao’s stage-structured approach was built. Furthermore, we established a test protocol for timestep validation which Chao’s simulator passed. We evaluated Chao’s simulator’s dependence on the random number generator, which was shown to be negligible. Finally, we evaluated the simulator output and our major result is the discovery of a secondary response to a primary infection, an occurrence is not shown in Chao’s dissertation. A tertiary response to the infection is never possible due to the size of the secondary response caused by memory cells.

2005

Microtissue models for studying the dynamics of host-pathogen interactions in the urinary bladder

Kunal Sharma

Urinary tract infections (UTIs) are amongst the most common bacterial infections and are the second-most frequent reason for antibiotic prescriptions. Moreover, in about 25% of all treated cases, recurrence of infection occurs. Uropathogenic Escherichia coli (UPEC) is the most common causative agent of UTIs. Much of our current understanding about UTIs has come from mouse models of UTI which have highlighted the intracellular lifestyle of this pathogen in the forms of intracellular bacterial communities (IBCs) as the prominent cause for bacterial persistence. Recurrent infections are thought to be caused by bacterial fluxing from persistent IBCs in the umbrella cell layer of the epithelia in the bladder. Although in vitro model systems of UTIs have been developed to study acute phases of infection including the formation of IBC and their dispersal, they suffer from certain shortcomings. For example, these models lack vasculature and the possibility to impose mechanical stresses, such as those experienced by the cells during bladder filling and voiding. Moreover, the design of these in vitro systems makes it difficult to study long-term UPEC persistence when exposed to antibiotic or neutrophil-mediated stresses. In the last two decades, two bioengineering approaches have emerged to generate functional and physiological tissues: organoid and organ-chip systems. Differentiating cells self-organize in a hydrogel and enable the formation of organoids, which mimic various aspects of organ physiology and function in a three-dimensional structure. Organ-chip systems rely upon co-culturing pre-differentiated cells across a synthetic membrane in a defined geometry. The organ-chip systems allow dynamic control over environmental (nutritive) state and over the mechanical stresses experienced by the emulated tissue. In this thesis, I showcase the development of model systems to study UPEC pathogenesis using both these approaches. In the first part of this thesis, we developed a bladder organoid model of UPEC infection that recapitulates the stratified bladder architecture within a volume suitable for high-resolution live-cell imaging. Bacteria injected into the organoid lumen rapidly enter umbrella cells and proliferate to form IBCs. Unexpectedly, we identified populations of individual âsolitaryâ bacteria that form independently of IBCs and which penetrate deeper layers of the organoid wall, and evade killing by antibiotics and neutrophils. Volumetric electron microscopy revealed that these solitary bacteria may be intracellular or pericellular (sandwiched between uroepithelial cells) and are rod-shaped and flagellated, unlike coccoid-shaped and unflagellated bacteria within IBCs. Bacterial fluxing from IBCs is therefore not an essential requirement for the establishment of persistent bacterial populations in the bladder wall. The dynamic responses of IBCs to host stresses and antibiotic therapy are difficult to assess in situ. In another study, we focussed on examining the lifecycle and persistence of IBCs during early stages of UTIs. We developed a human bladder-chip model wherein superficial umbrella cells and bladder microvascular endothelial cells are co-cultured under flow in urine and nutritive media respectively. Bladder filling and voiding was mimicked mechanically by application and release of linear strain. Using time-lapse microscopy, we show that rapid recruitment of neutrophils from the vascular channel

EPFL2021

Neonatal Manifestations of Chronic Granulomatous Disease: MAS/HLH and Necrotizing Pneumonia as Unusual Phenotypes and Review of the Literature

Alessandro Borghesi

Chronic granulomatous disease (CGD) is a rare inborn error of immunity (IEI), characterized by a deficient phagocyte killing due to the inability of NADPH oxidase to produce reactive oxygen species in the phagosome. Patients with CGD suffer from severe and recurrent infections and chronic inflammatory disorders. Onset of CGD has been rarely reported in neonates and only as single case reports or small case series. We report here the cases of three newborns from two different kindreds, presenting with novel infectious and inflammatory phenotypes associated with CGD. A girl with CYBA deficiency presented with necrotizing pneumonia, requiring a prolonged antibiotic treatment and resulting in fibrotic pulmonary changes. From the second kindred, the first of two brothers developed a fatal Burkholderia multivorans sepsis and died at 24 days of life. His younger brother had a diagnosis of CYBB deficiency and presented with Macrophage Activation Syndrome/Hemophagocytic Lympho-Histiocytosis (MAS/HLH) without any infection, that could be controlled with steroids. We further report the findings of a review of the literature and show that the spectrum of microorganisms causing infections in neonates with CGD is similar to that of older patients, but the clinical manifestations are more diverse, especially those related to the inflammatory syndromes. Our findings extend the spectrum of the clinical presentation of CGD to include unusual neonatal phenotypes. The recognition of the very early, potentially life-threatening manifestations of CGD is crucial for a prompt diagnosis, improvement of survival and reduction of the risk of long-term sequelae.

SPRINGER/PLENUM PUBLISHERS2021

Microtissue models for studying the dynamics of host-pathogen interactions in the urinary bladder

Kunal Sharma

EPFL2021