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Recurrent UTIs linked to gut microbiome, chronic inflammation

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

Design analysis and sample collection for UMB analysis. Credit: Nature Microbiology (2022). DOI: 10.1038 / s41564-022-01107-x

One of the major concerns about urinary tract infections (UTIs) is that they recur. UTIs cause infections in the bladder and have a lot of urination and pain. Round of antibiotics usually eliminates the symptoms, but often more frequently than temporary: one-fourth of women continue to develop a second UTI within six months. Some underprivileged get UTI regularly, and need antibiotics every few months.

A new study suggests that women with upcoming UTIs could be caught in another bad cycle which antibiotics given to eliminate one infection cause them to cause another. The study, by researchers at the University of Washington School of Medicine at St. Conducted by Louis and the Broad Institute of MIT and Harvard, have shown that a round of antibiotics eliminates the pathogens that cause infections. bacteria from the bladder but not from the intestine. Surviving cells in the intestine can multiply and spread to the bladder, causing an UTI.

At the same time, the cycle of antibiotics destroys the community of beneficial bacteria that usually live in the gut, the so-called gut microbiome. Similar to other diseases of the intestinal microbes and immune system are related, women with recurrent UTI in the study had lower levels of pathogens that were less abundant in an important group of cells that helped regulate inflammation, and a specific immune response in their blood. indicates inflammation.

The study was published on May 2 Nature Microbiology.

“It is unfortunate for women to go to the doctor with a relapse after their relapse, and the doctor, who is usually a male, advises them on hygiene,” said lead author Scott J. Hultgren, Professor Helen L. Stoever. He studied Molecular Microbiology at the University of Washington. “It’s not necessarily the cause of the problem, it is not necessarily the cause of the poor hygiene, the problem is in the damage itself, depending on the intestine and the bladder and the degree of inflammation. Basically, doctors do not know what to do. with repeated UTI. “Everything they have is antibiotics, so they throw more antibiotics into the problem, which may make things worse.”

Most UTIs cause Escherichia coli (E. coli) bacteria from the intestine that enters the stomach. urinary tract. To understand why some women become infected after infecting others and get one or the other, Hultgren teamed up with Broad Institute scientists Ashlee Earl, senior president of the Bacterial Genomics Group in Broad and the lead author of the paper, and Colin Worby, a mathematician and lead author.

The researchers studied 15 women with a history of recurrent UTI and 16 women with no. All participants donated urine as well blood sample at the beginning of the study the monthly stool products. The team examined the bacteriological properties of the stool samples, tested urine for the presence of bacteria, and measured the biological information in the blood samples.

Over the course of one year, 24 UTIs occurred, all in participants with a history of recurrent UTIs. When participants were diagnosed with UTI, the team took extra urine, blood and stool samples.

The differences between women who repeated UTIs and those who did not, surprisingly, did not come to the point of E. coli in their intestines or even the presence of E. coli in the bladder. Both groups carry E. coli strains in their intestines that can cause UTIs, and such strains occasionally spread to the bladder.

The real difference is in the makeup of the intestinal microbiomes. Patients with recurrent infections show a marked reduction in the diversity of healthy intestinal pathogens, which may provide additional opportunities for the pathogens that cause inflammation and inflammation. In particular, microbiomes of female UTIs are highly deficient in bacteria that produce butyrate, a short chain of fatty acid with anti-inflammatory effects.

“We think the women in the group were able to remove the bacteria from the bladder before they caused the infections, too mata with recurrent UTI are not present, due to specific immune responses to bladder infection that may be mediated by internal microbiomesaid Worby.

The results of the study highlight the importance of finding effective ways to treat UTIs.

“Our research clearly shows that antibiotics do not prevent future infections or clear the UTI-causing strains from the intestine, and that they can cause recurrence by keeping the microbiome in a safe place,” she said. Worby.

Hultgren has long been working on finding new therapies to eradicate the E. coli-causing pathogens from the body as well as isolating other viral communities. His research provides the basis for an experimental drug that relies on sugar mannoside and antibiotics, both of which are being tested in humans. Another strategy is to reorganize the microbiome through fecal transplants, probiotic diets or other methods.

“This is one of the most common diseases in the United States, if not the world,” Hultgren said. “A good percentage of these UTI patients continue to experience these recurrences on a regular basis, and it results in a reduction in quality of life. There is a real need to provide improved therapies that break this vicious cycle.”


New drug reduces E. coli, may provide alternative antibiotics


Learn more:
Scott Hultgren, Longitudinal Multi-omics studies linking gut microbiome dysbiosis with recurrent urinary tract infections in women, Nature Microbiology (2022). DOI: 10.1038 / s41564-022-01107-x. www.nature.com/articles/s41564-022-01107-x

hint: Repetitive UTIs related to gut microbiome, regular inflammation (2022, May 3) Retrieved 3 May 2022 from https://medicalxpress.com/news/2022-05-recurrent-utis-linked- gut-microbiome.html

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