Changes to host metabolism, such as pregnancy or development of type 2 diabetes, are associated with urogenital infections. Diabetic and pregnant women are more likely to develop a UTI and more often progress with complications including recurrent UTI, pyelonephritis, and urosepsis. Diabetic and pregnant women are also disproportionately infected by certain opportunistic pathogens, such as group B Streptococcus. We seek to identify and understand the key metabolic factors that initiate this increased risk of infection.
Multiple immune factors protect the urogenital tract from invading bacterial pathogens including antimicrobial peptides, iron-binding proteins, and soluble proteins that prevent bacteria from attaching to the tissue itself. Many of these host defenses also play a role in modulating the host immune response. Additionally, these same factors are impacted by pregnancy and metabolic disease. Learning more about how the host immune response influences the susceptibility to infection will allow us to potentially explore new therapeutic targets for diseases of the urinary and vaginal tracts.
Most of the bacterial pathogens that cause urinary tract infections are resident organisms of the bacterial communities that colonize the gastrointestinal or vaginal tracts (microbiota). Not all women are colonized however, and some bacterial communities resist colonization by these pathogens. We seek to understand how these pathogens persist as a member of the microbiota in some individuals, and we hope to discover how these bacteria switch from being a commensal bacteria to an invasive pathogen.
Group B Streptococcus
Group B Streptococcus (GBS) colonizes the vaginal mucosa of one in four healthy women, yet during pregnancy, GBS creates a risk of serious disease in the vulnerable newborn and mother. Antibiotic prophylaxis to GBS-positive mothers during labor has reduced GBS neonatal disease, but there are several unintended consequences including altered neonatal gut bacteria. We seek to understand how GBS competes with the vaginal microbiota to achieve colonization, and to develop innovative preventions which display GBS-targeted antimicrobial activity while leaving the maternal microbiota intact.
Uropathogenic E. Coli
Uropathogenic E. Coli (UPEC) is the leading cause of urinary tract infections (UTI) in women. Risk of UTI is higher during pregnancy (affecting ~10 percent of women) and is associated with serious infections (kidney infection) and adverse birth outcomes. We seek to understand the factors driving these complications to develop new strategies to treat or prevent UTI in pregnancy.