Dear Colleagues,

For this Special Issue of Pathogens, we focus on uropathogens. Of particular concern is the rise in the incidence of urosepsis. A recent investigation of the prevalence of sepsis worldwide demonstrated a continuing decline in episodes of sepsis except for patients experiencing urosepsis [1]. Urosepsis is an overwhelming infection that originates in the urinary tract and spreads to the bloodstream, causing substantial morbidity and in some cases mortality. In adults, urosepsis accounts for 25% of all cases of sepsis [2]. 

In this issue, we hope to discuss new insights into the activity of uropathogens and the pathogenesis of urinary tract infections and urosepsis. We welcome a robust discussion of various uropathogens including less common pathogens and the role they may play in the rising numbers of urosepsis as well as the development of urinary tract infections. We look forward to considerations of the changing activity of pathogens in the urinary tract as compared to other areas of the body, new insights into the mechanisms of action of the more commonly recognized uropathogens and the potential role of the various microbiomes.

We recognize the role that the immune response plays in the pathophysiology of urosepsis is substantial and welcome articles on the involvement of cytokines in this process as well as the interplay of other aspects of the immune response.

Clinically, urosepsis occurs primarily due to obstruction or secondary to infected material in the urinary system. This Special Issue will address the clinical correlates of urosepsis, some of the clinical causes of urosepsis, and the identification and management of this disease. Recent work has suggested a connection between current clinical practice and the increasing incidence of urosepsis [3]. We intend for this phenomenon to be addressed.

This issue of Pathogens is expected to incorporate basic research as well as discussions of clinical management. We will end with a discussion of the treatment of urosepsis which must include considerations of early and late diagnosis, new definitions for the classification of sepsis, and an examination of goal-directed therapy and ongoing prevention practices.

References

1. Kempker, J.A.; Martin, G.S. A global accounting of sepsis. Lancet 2020, 18, 168–170.
2. Rudd, K.E.; Johnson, S.C.; Agesa, K.M.; Shackelford, K.A.; Tsoi, D.; Kievlan, D.R.; Colombara, D.V.; Ikuta, K.S.; Kissoon, N.; Finfer, S.; et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: Analysis for the Global Burden of Disease Study. Lancet 2020, 18, 200–211.
3. Wagenlehner, F.M.E.; Bjerklund Johansen, T.E.; Cai, T.; Koves, B.; Kranz, J.; Pilatz, A.; Tandogdu, Z. Epidemiology, definition and treatment of complicated urinary tract infections. Nat. Rev. Urol. 2020, 17, 586–600.

Dr. Kymora B. Scotland
Prof. Dr. Michel A. Pontari
Guest Editors

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• uropathogens
• urosepsis
• urinary tract infections
• microbiome
• disease management