Enterobacteriaceae, recurrent urinary tract infections associated with chronic inflammation

Nature Microbiology (2022). DOI: 10.1038 / s41564-022-01107-x “width =” 800 “height =” 530 “/>

Study design and sample collection for UMB studies. credit: Nature microbiology (2022). DOI: 10.1038 / s41564-022-01107-x

One of the biggest complaints about urinary tract infections (UTIs) is their frequent recurrence. UTI is caused by bacteria in the urinary tract and is characterized by frequent and painful urination. Rounds of antibiotics usually eliminate symptoms, but relief is often temporary: a quarter of women continue to develop a second UTI within 6 months. Some unhappy people receive UTIs multiple times and need antibiotics every few months.

A new study shows women with recurrent urinary tract infections Virtuous circle Antibiotics given to eradicate one infection make it more likely to develop another.This study by researchers at Washington University in St. Louis and the Broad Institute at MIT and Harvard University showed that a round of antibiotics eliminates the cause of the disease. Bacteria From the bladder, but not from the intestines. Bacteria that survive in the intestine can multiply and spread back to the bladder, causing another UTI.

At the same time, repeated cycles of antibiotics cause havoc to the community of useful bacteria that normally live in the gut, the so-called gut flora.Gut microbiota Immune system In a study associated with women with recurrent urinary tract infections, there is a lack of important bacterial populations that help regulate inflammation. There was a scientific feature.

The study will be published on May 2nd Nature microbiology..

Scott J. Hartgren, co-chief author of Professor Helen L. Stover, said: He holds a PhD in Molecular Microbiology from the University of Washington. “It’s not necessarily what the problem is. It’s not necessarily the poor hygiene that causes this. The problem is in the disease itself, in this connection between the intestines and the bladder and the level of inflammation. Basically, doctors don’t know what to do. Relapsed urinary tract infections. They only have antibiotics, so give more antibiotics to the problem, which is probably It just makes things worse. “

Most UTIs are caused by E. coli, which has invaded the intestines. Urinary tract.. To understand why some women are infected after infection and others, Hultgren, with Ashlee Earl, a senior group leader and co-author of the paper, Broad’s Bacterial Genomics Group, a scientist at the Broad Institute. Computational biologist and lead author of the dissertation.

The researchers studied 15 women with a history of recurrent urinary tract infections and 16 women without it. All participants donated urine and Blood sample Stool samples at the start of the study and monthly. The team analyzed bacterial composition in stool samples, tested for the presence of bacteria in urine, and measured gene expression in blood samples.

Twenty-four UTIs occurred during the year, all of which were participants with a recurring history of UTIs. When participants were diagnosed with UTI, the team took additional urine, blood, and stool samples.

The difference between women who had repeated urinary tract infections and those who did not was surprisingly not due to the type of E. coli in the intestines or even the presence of E. coli in the bladder. Both groups had E. coli strains in the intestine that could cause UTI, and such strains could spread to the bladder.

The real difference was in the composition of the intestinal microbiome. Patients with repeated infections showed reduced diversity of healthy gut microbial species. This can increase the chances that the disease-causing species will build a foothold and multiply. In particular, the microflora of women with recurrent urinary tract infections was particularly deficient in bacteria that produce butyric acid, a short-chain fatty acid with anti-inflammatory properties.

“I think the women in the control group were able to get rid of the bacteria from their bladder before they caused the disease. woman In recurrent urinary tract infections, due to a clear immune response to the invasion of bacteria into the bladder, Gut microbiota“Warby said.

The findings emphasize the importance of finding antibiotic alternatives to treat UTIs.

“Our study shows that antibiotics do not prevent future infections or remove UTI-causing strains from the gut, but keep the microbial flora in a destroyed state, which can lead to recurrence. It clearly shows that it has the potential to increase the risk of infection, “says Worby.

Hultgren has long been working on discovering innovative therapies to eradicate the strains responsible for E. coli disease from the body while preserving the remaining bacterial community. His work forms the basis of experimental drugs based on sugar mannosides and clinical trial vaccines, both of which have been tested in people. Another strategy is to rebalance the microbial flora through fecal transplants, probiotic foods, or other means.

“This is one of the most common infectious diseases in the United States, if not the world,” says Hultgren. “A significant proportion of these UTI patients continue to develop these chronic recurrences, which results in poor quality of life. It is really necessary to develop better treatments to break this virtuous circle.”

New treatments may reduce E. coli and provide an alternative to antibiotics

For more information:
Scott Hartgren, longitudinal multi-omics analysis correlates dysbiosis of the intestinal flora with recurrent urinary tract infections in women. Nature microbiology (2022). DOI: 10.1038 / s41564-022-01107-x..

Quote: Recurrent UTI associated with gut microbiota, chronic inflammation (May 3, 2022), https: // Acquired on May 3, 2022

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Enterobacteriaceae, recurrent urinary tract infections associated with chronic inflammation

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