Host-pathogen interaction in urinary tract infection. Antibacterial therapy strategy
Zakharova I.N., Osmanov I.M., Bekmurzaeva G.B., Churilova V.D., Anisimova P.D.
Urinary tract infection (UTI) is a common pathology in the pediatric population. A significant problem with this pathology is the high recurrence rate against the background of increasing antimicrobial resistance. Predisposition to recurrent UTIs is determined by the patient’s gender, urodynamic abnormalities, the presence of comorbidities, and the balance between the host’s defense mechanisms and the virulent potential of uropathogenic microorganisms. Key to the disease’s pathogenesis is a set of virulence factors, including adhesins, toxins, siderophores, and autotransporter proteins, which facilitate urinary tract colonization, invasion of epithelial cells, and evasion of the immune system and antimicrobial agents. This is made possible by the formation of intracellular colonies, reservoirs, and biofilms. With increasing antibiotic resistance, research into the mechanisms of resistance development, analysis of regional patterns of microbial resistance, and rational pharmacotherapy, including optimization of drug dosing regimens, are particularly relevant. This article examines this problem with an emphasis on the role of pathogen virulence factors, using uropathogenic E. coli as an example, as the most common and best-studied pathogen causing UTIs in the pediatric population. The article provides a detailed analysis of the mechanisms of interaction between pathogenic microorganisms and the host, highlighting the tricks used by pathogens to evade the immune response, the action of antibacterial drugs, and to reactivate the inflammatory process. The aim of the article is to systematize current knowledge for clinicians and researchers, contributing to the improvement of the diagnosis, prevention, and treatment of UTIs in the context of growing antibiotic resistance.
For citations: Zakharova I.N., Osmanov I.M., Bekmurzaeva G.B., Churilova V.D., Anisimova P.D. Host-pathogen interaction in urinary tract infection. Antibacterial therapy strategy. Pharmateca. 2026;33(3):6-15. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.3.6-15
Authors’ contribution: All authors contributed equally to this work and writing of the article at all stages.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Keywords
children
urinary tract infection
antibacterial therapy
cefixime
antibiotic resistance
virulence factors
About the Authors
Irina N. Zakharova, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Head of the Department of Pediatrics named after G.N. Speransky, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; zakharova-rmapo@yandex.ru, ORCID:https://orcid.org/0000-0003-4200-4598
Ismail M. Osmanov, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Honored Doctor of Moscow, Chief Physician, Z.A. Bashlyaeva Children’s City Clinical Hospital; Director of the University Pediatric Clinic, Pirogov Russian National Research Medical University, Moscow, Russia; osmanovim@zdrav.mos.ru, ORCID: https://orcid.org/0000-0003-3181-9601
Gulfizat B. Bekmurzaeva, Cand. Sci. (Med.), Head of the Nephrology Department, Nephrologist, Z.A. Bashlyaeva Children’s City Clinical Hospital, Department of Health of the City of Moscow; Russian Medical Academy of Continuous Professional Education, Moscow, Russia; gulfizat@inbox.ru, ORCID: https://orcid.org/0000-0002-0168-2846
Viktoria D. Churilova, Postgraduate Student, Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; vika.churilova.2020@yandex.ru, ORCID: https://orcid.org/0000-0003-4200-4598
Polina D. Anisimova, Postgraduate Student, Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; amstaffanis@gmail.com, ORCID: https://orcid.org/0009-0007-4550-1502 (corresponding author)
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