Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI

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...

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Main Authors: Björn Wullt, Catharina Svanborg
Format: Article
Language:English
Published: MDPI AG 2016-07-01
Series:Pathogens
Subjects:
Online Access:http://www.mdpi.com/2076-0817/5/3/52
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author Björn Wullt
Catharina Svanborg
author_facet Björn Wullt
Catharina Svanborg
author_sort Björn Wullt
collection DOAJ
description 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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spelling doaj.art-7716a8ffd891420f841e7538b7d04aa42022-12-22T02:14:59ZengMDPI AGPathogens2076-08172016-07-01535210.3390/pathogens5030052pathogens5030052Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTIBjörn Wullt0Catharina Svanborg1Department of Microbiology, Immunology and Glycobiology (MIG), Institute of Laboratory Medicine, Lund University, 221 00 Lund, SwedenDepartment of Microbiology, Immunology and Glycobiology (MIG), Institute of Laboratory Medicine, Lund University, 221 00 Lund, SwedenWe 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.http://www.mdpi.com/2076-0817/5/3/52asymptomatic bacteriuria (ABU)therapeutic efficacyvirulence
spellingShingle Björn Wullt
Catharina Svanborg
Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI
Pathogens
asymptomatic bacteriuria (ABU)
therapeutic efficacy
virulence
title Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI
title_full Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI
title_fullStr Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI
title_full_unstemmed Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI
title_short Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI
title_sort deliberate establishment of asymptomatic bacteriuria a novel strategy to prevent recurrent uti
topic asymptomatic bacteriuria (ABU)
therapeutic efficacy
virulence
url http://www.mdpi.com/2076-0817/5/3/52
work_keys_str_mv AT bjornwullt deliberateestablishmentofasymptomaticbacteriuriaanovelstrategytopreventrecurrentuti
AT catharinasvanborg deliberateestablishmentofasymptomaticbacteriuriaanovelstrategytopreventrecurrentuti