Woman Suffers Chronic UTIs For 45 Years
The intestine may be a new source of hope for suffers of chronic urinary tract infections, otherwise known as UTIs.
Approximately 25 percent of women who suffer the excruciating burn of a UTI will experience a recurrent infection within six months. Plenty will continue to suffer many more episodes, according to the University of Queensland's Professor Mark Schembri, leaving them with "a chronic, debilitating condition with no effective cure".
To make matters worse, the problem is exacerbated by increasing antibiotic resistance.
However, new research led by UQ in conjunction with a team of researchers from the University of Utah in the United States has found for the first time evidence of infections originating in the intestine (rather than the bladder), opening up new avenues of treatment.
They examined a patient who has experienced chronic UTIs for 45 years. The American woman, who is now aged 82, first began experiencing UTIs following a vaginal hysterectomy in 1971.
Despite taking "almost every type of antibiotic" available, including "some of the strongest antibiotics available in our armoury", the bacteria "has been able to survive and escape treatment", Schembri said.
The only relief she's had in almost half a century was a nine-month window. Even surgery to remove 12-inches of her colon after doctors became concerned about its proximity to her bladder didn't help; her infection always came back.
"I think it's fair to say this was a debilitating condition for this patient," Schembri told 10 daily.
It was only when researchers isolated E. coli from the patient's urine and sequenced its entire DNA that they were able to begin shedding some light on why she was suffering near-constant infections.
They also sequenced DNA of E. coli in her intestine and compared the two. The results were a match.
"[The E. coli from her faecal samples] were the same as those that caused the recurring UTI, proving that the woman had a persistent reservoir of E. coli residing in her intestine -- the source of her infections," UQ's Associate Professor Scott Beatson said.
It's the first time science has shown bacteria can reside in the intestine for long periods of time and cause recurring UTIs, despite antibiotic treatment.
"Therefore, it's time we consider using antibiotics that will not just treat the UTI in the bladder, but also eliminate the infection reservoir in the intestine that seeds recurrent infection of the bladder," Beatson said.
Schembri added that the patient -- who for ethical reasons cannot be named -- has the longest history of recurrent UTIs his team has ever come across.
"However, what is not known is how many other patients out there are suffering the same condition," he said.
"In some ways, this could be described as the 'silent epidemic'."
Further to that, he added, increasing antibiotic resistance will likely magnify the problem of recurrent UTIs in the coming years.
"[It highlights] the urgent need to come up with new treatment solutions," Schembri said.
For the woman at the centre of this case, successful treatment remains elusive. Researchers, however, remain hopeful.
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