Are Adaptable Bacteria the Cause of Repeat Urinary Tract Infections?
Those women who suffer from recurring urinary tract infections may be carrying a hearty strain of E. coli bacteria that is capable of flourishing in both the bladder and the gut and migrates back and forth despite repeated treatments, according to a small new study.
Urinary tract infections are typically thought to be caused by E. coli which migrates from the gut to the urinary tract. The study's background information assumed that when the bacteria go to the bladder it then loses its ability to flourish in the gastrointestinal tract.
The research published May 8, 2013 in the journal Science Translational Medicine suggests that some forms of E. coli may be more adaptable than doctors had previously realized.
The multinational team of researchers studied a group of women who suffered from repeated episodes of urinary tract infections and discovered the particularly aggressive strain of E. coli can survive in both the bladder and the gut.
"The idea was the ability to effectively colonize the urinary tract was inversely correlated to the ability to effectively colonize the (gastrointestinal) tract," said microbiologist Michael Hibbing, who is with Washington University in St. Louis and the study's co-author. "We found that dichotomy wasn't necessarily true. We found one strain of E. coli that is very good at colonizing both the GI tract and the urinary tract."
According to the study, more than half of all women develop at least one urinary tract infection during their lifetimes. Nearly a quarter of all women have experienced recurrent urinary tract infections, including two or more episodes within a six-month period.
The research team discovered the adaptable E. coli strains when studying 45 different strains of the bacteria from the urine and feces of four women who were otherwise healthy but who were experiencing successive urinary tract infections.
Two of the women were found to play host to a dominant strain of E. coli that not only survived but thrived in both the urinary tract and the gut during three urinary tract infections occurring over several months.
The other two women had an E. coli strain present in the gut and bladder that changed as the patients suffered recurring urinary tract infections. The researchers found that the strain causing the initial infection was replaced by a stronger strain of E. coli that fared even better in both the gut and the bladder.
The study concluded the research results open the possibility that treating recurrent urinary tract infections may be more complex than physicians had previously believed if the bacteria causing the infections can move freely between the gastrointestinal tract and the urinary tract.
Dr. Linda Brubaker, a urogynecologist who was not involved in the study, states, "It opens the possibility that bacteria interact with each other, and depending on how the bacteria interact may determine whether a woman gets a single or recurring urinary tract infection. The solution is probably not going to be more antibiotics, but a deeper understanding of a specific woman's risk based on the bacteria that live in her bladder or her bowel."
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