A UT Southwestern study suggests why urinary tract infections (UTIs); have such a high recurrence rate in postmenopausal women several species of bacteria can invade the bladder walls. UTI treatment is the most common reason for antibiotic prescriptions in older adults. Because of the prevalence of UTIs, the societal impact is high and treatment costs billions of dollars annually.
“Recurrent UTI (RUTI) reduces the quality of life; places a significant burden on the health care system, and contributes to antimicrobial resistance. The investigation demonstrates that several species of bacteria can work their way inside the human bladder’s surface area; called the urothelium, in RUTI patients. Bacterial diversity, antibiotic resistance, and the adaptive immune response all play important roles in this disease; the study suggests.
RUTIs in postmenopausal women
“Therefore the findings represent a step in understanding RUTIs in postmenopausal women. “They will need to use methods other than antibiotics to treat this disease; as now they observe diverse types of bacteria in the bladder wall of these patients.” Since the advent of antibiotics in the 1950s; but patients and physicians have relied on antibiotics for UTI treatment.
“As time went on, however, 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 on the line;” said Dr. Philippe Zimmern, Professor of Urology and a co-senior author. “Therefore, but this new body of data in women affected by RUTIs exemplifies what a multidisciplinary collaboration can achieve going back; forth between the laboratory and the clinic.”
Bacterial infections in women
UTIs are one of the most common types of bacterial infections in women, accounting for nearly 25 % of all infections. So recurrence can range from 16-36 % in premenopausal women to 55 % following menopause. Factors thought to drive higher UTI rates in postmenopausal women include pelvic organ prolapse, diabetes, lack of estrogen, loss of Lactobacilli in the vaginal flora; increased colonization of tissues surrounding the urethra by Escherichia coli (E. coli).
Therefore the UTSW team, so which including researchers from Molecular Biology, Pathology, Urology, and Biochemistry, bacteria in bladder biopsies from 14 RUTI patients using targeted fluorescent markers, a technique that had not used to look for bacteria in human bladder tissue. Accessing human tissue was key, the researchers note; but as the field has largely relied on mouse models that are to lifespans of 1.3 to 3 years, depending on the breed.
Therefore this is direct evidence in postmenopausal women affected with RUTIs; a segment of our population that has grown with the aging of baby boomers and longer life expectancy in women.” Future studies will focus on determining effective techniques to remove these bacteria and chronic inflammation from the bladder; finding new strategies to enhance immune system response and pinpointing the various bacterial pathogens involved in RUTIs.