A new finding by researchers at The University of Texas at Dallas and UT Southwestern Medical Center shows that several species of bacteria reside in bladder tissue of postmenopausal women who experience recurrent urinary tract infections (RUTIs).  The results, publish online April 17 in the Journal of Molecular Biology, represent the first systematic analysis of biopsies from patients in this population. The findings provide a better understanding of the interaction between bacteria and host tissue, which might lead to more effective treatment strategies.

Effectively with antibiotics

Urinary tract infections (UTIs) are irritating and painful; so sometimes debilitatingly so. The majority of UTIs are cause by the bacterium Escherichia coli; which normally lives in human intestines but sometimes gets into the urinary tract; so where it is not welcome. The infections, which predominantly occur in women; so typically can be treat effectively with antibiotics.

But for some postmenopausal women, UTIs recur so frequently that they become a chronic condition; so requiring daily doses of increasingly powerful antibiotics; so as the infection causing bacteria gradually become resistant to each new drug. For older women, these infections can go on for tens of years,” said Dr. Nicole De Nisco; assistant professor of biological sciences at UT Dallas and lead author of the study. “Eventually, a patient’s last resort might be removing the bladder.

Most of the epidemiological research on UTIs has done with women in their 20s and 30s; so a much earlier age range than the typical onset of menopause. One of the reasons urinary tract infections have been overlook is because they affect women; hence an understudy group in general when it comes to disease, and older women in particular, who are even more understudied,” De Nisco said.

The pathogenic mechanisms

To investigate the pathogenic mechanisms and immune responses relate to recurring UTIs, De Nisco and her colleagues analyze urine and biopsies from 14 postmenopausal women who had undergone cystoscopy with fulguration of trigonitis, a procedure aim at treating antibiotic-resistant UTIs by removing inflame bladder tissue.

They found that in addition to the expect E. coli, bacteria in urine samples include Klebsiella pneumoniae and Enterococcus faecalis, while species in biopsied tissue include E. coli, Staphylococcus hominis and Bacillus firmus. Our findings confirm that bacteria do form communities within the bladder wall of RUTI patients; which was not previously know,” De Nisco said. “This research is a critical step toward better understanding the mechanisms of recurring urinary tract infection and inflammation in postmenopausal women.”