Ana Lidia Flores-Mireles Hawk Assistant Professor

Bacterial Pathogenicity in Catheter-Associated Infections
Ana Lidia Flores-Mireles

Research Interests:

Catheter-associated urinary tract infections (CAUTIs) are the most common cause of healthcare associated infection (HAI) worldwide, accounting for 40% of all HAIs with more than one million cases diagnosed annually in hospitals and nursing homes in the United States and Europe and it accounts for an annual cost of $340–370 million. Importantly, CAUTI often leads to secondary bloodstream infection with a seven day mortality rate of more than 30%. This becomes more troublesome since urinary catheters use is exceedingly common in health care facilities and it is estimated that 20-50% of all hospitalized patients receive a urinary catheter, which accounts for >30 million Foley catheters inserted annually in the United States, resulting in 1 million CAUTIs. The presence of a urinary catheter changes the bladder environment allowing several pathogens such as Enterococcus spp., Staphylococcus aureus, Candida spp., Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa and Group B Streptococcus, to colonize the bladder, something that otherwise would not occur (22, 23). From these groups of bacteria, Enterococcus spp. are the leading cause of CAUTI, have emerged as a frequent cause of HAIs, and their treatment are increasingly challenging due to their intrinsic and acquired resistance to antibiotics. Currently, 30% of all enterococcal HAI isolates are resistant to vancomycin, leading the CDC to classify VRE as a serious threat, recommending monitoring and the development of new therapeutic strategies. My lab is interested in understanding how urinary catheterization-induced inflammation renders the host susceptible to microbial infection of the urinary tract and subsequent dissemination. My lab is also interested in deciphering key host and pathogen determinants for infection and targeting them to develop novel antibiotic-sparing therapies.



  • Assistant Professor, Department of Biological Sciences, University of Notre Dame, Notre Dame, IN  2018 – Present
  • Staff Research Scientist, Molecular Microbiology Department, Washington University School of Medicine, St. Louis, MO  2017 – 2018
  • Postdoctoral Researcher, Molecular Microbiology Department, Washington University School of Medicine, St. Louis, MO  2012 – 2017
  • PhD, Microbiology, Cornell University, Ithaca, NY  2011


Selected Publications:

  • Xu, W, Flores-Mireles AL, Cusumano ZT, Takagi E, Hultgren SJ, Caparon MG. 2017. Host and bacterial proteases influence biofilm formation and virulence in a murine model of enterococcal catheter-associated urinary tract infection. NPJ Biofilms and Microbiome. 2017 Nov 6;3:28. doi: 10.1038/s41522-017-0036-z.
  • Walker JN, Flores-Mireles AL, Pinkner, CL, Schreiber HLt, Joens MS, Park AM, Potretzke AM, Bauman TM, Pinkner JS, Fitzpatrick JAJ, Desai A, Caparon MG, Hultgren SJ. 2017. Catheterization alters the bladder ecology to potentiate Staphylococcus aureus infection of the urinary tract. PNAS. Published ahead of print September 25, 2017, doi:10.1073/pnas.1707572114
  • Flores-Mireles A. L., Walker JN, Potretzke AM, Schreiber HLt, Pinkner JS, Bauman TM, Park AM, Desai A, Hultgren SJ, Caparon MG. 2016. Antibody-based therapy for enterococcal catheter-associated urinary tract infections. 7(5).
  • Flores-Mireles A. L., Walker JN, Bauman TM, Potretzke AM, Schreiber HLt, Park AM, Pinkner JS, Caparon MG, Hultgren SJ, Desai A. 2016. Fibrinogen Release and Deposition on Urinary Catheters Placed during Urological J Urol 196:416-421.
  • Highlighted in UroToday
  • Flores-Mireles, A. L., Pinkner, J. S., Caparon, M. G., and Hultgren, S. J. An EbpA adhesin vaccine prevents catheter-associated UTI by blocking Enterococcus faecalis biofilms formed by exploitation of fibrinogen. Science Translational Medicine.
  • Conover, M. S., Flores-Mireles, A. L., Hibbing, M. E. Dodson K, Hultgren SJ. Establishment and Characterization of UTI and CAUTI in a Mouse Model. J Vis Exp: e52892.
  • Flores-Mireles A. L., Walker JN, Caparon M, Hultgren SJ. 2015. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol 13:269-284.