Antibiotic resistance causes high recurrence rate of UTIs

14 May 2019

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A study undertaken by the University of Texas Southwestern (UTSW) Medical Centre suggests that a high rate of recurrent urinary tract infections (RUTIs) in post-menopausal women is linked to bacterial diversity and antibiotic resistance.
Tiffany Hionas

UTI treatment is one the prevalent reasons for antibiotic prescriptions in older adults. However, this comes with subsequent challenges. Emerging antibiotic allergy and resistance issues is forcing medical professionals to use methods other than antibiotics to treat the condition.

In addition to these challenging issues, recurring UTIs reduce the quality of life in the affected individual and places a burden on the healthcare system, with treatment costing billions.

The study shows that several species of bacteria can invade the walls of the bladder, known as the urothelium in RUTI patients. The UTSW team are testing a new technique which involves using targeted fluorescent markers to examine bacteria in bladder biopsies from 14 RUTI patients.

The bacteria studied by a team at UT Dallas – also part of the UT university network – was discovered to be able to work its way deep inside human bladder tissue, past the urothelium layer. It was also discovered that the adaptive immune response is active in human RUTIs, which plays an important role in the condition.

Patients and physicians have heavily relied on antibiotics for UTI treatment since the 1950s. However, because of the growing epidemic of antibiotic resistance, the economic burden of treatment costs, and other health/biological factors driving higher UTI rates in postmenopausal women, it has become a necessity to reduce UTIs in women through new forms of treatments.

This is especially important as UTIs account for nearly 25% of all infections with recurrence ranging between 16-36% in premenopausal women and 55% following menopause, making UTIs the most common type of bacterial infection. Consequently, bacteria are becoming more resistant to antibiotic treatments.

‘Major antibiotic allergy and resistance issues have emerged, leading to very challenging and complex situations for which few treatment choices are left and one's life can be on the line,’ said Dr Philippe Zimmern, Professor of Urology and a co-senior author.

‘Therefore, this new body of data in women affected by RUTIs exemplifies what a multidisciplinary collaboration can achieve going back and forth between the laboratory and the clinic.’

With data explaining what contributes to UTIs, and with the new techniques allowing researchers to look for the bacteria in the human bladder, it seems the next step will be to discover which techniques can be used to be able to remove bacteria from the bladder and new strategies to enhance the immune system response.

DOI: 10.1016/j.jmb.2019.04.008 

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