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Deliberate establishment of asymptomatic bacteriuria—a novel strategy to prevent recurrent UTI

Wullt, Björn LU and Svanborg, Catharina LU (2016) In Pathogens (Basel, Switzerland) 5(3).
Abstract

We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli) 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to... (More)

We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli) 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Asymptomatic bacteriuria (ABU), Therapeutic efficacy, Vssirulence
in
Pathogens (Basel, Switzerland)
volume
5
issue
3
publisher
MDPI AG
external identifiers
  • scopus:85012025898
  • wos:000382511200008
ISSN
2076-0817
DOI
10.3390/pathogens5030052
language
English
LU publication?
yes
id
9434577e-694b-4888-a54d-7336c30ea3ad
date added to LUP
2017-03-03 13:50:51
date last changed
2017-09-24 05:08:20
@article{9434577e-694b-4888-a54d-7336c30ea3ad,
  abstract     = {<p>We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli) 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies.</p>},
  articleno    = {52},
  author       = {Wullt, Björn and Svanborg, Catharina},
  issn         = {2076-0817},
  keyword      = {Asymptomatic bacteriuria (ABU),Therapeutic efficacy,Vssirulence},
  language     = {eng},
  number       = {3},
  publisher    = {MDPI AG},
  series       = {Pathogens (Basel, Switzerland)},
  title        = {Deliberate establishment of asymptomatic bacteriuria—a novel strategy to prevent recurrent UTI},
  url          = {http://dx.doi.org/10.3390/pathogens5030052},
  volume       = {5},
  year         = {2016},
}