The urine infection It is a very frequent reason for consultation in primary care centers. It is estimated that approximately 400 million people a year. However, despite the frequency with which it is studied, the diagnosis and treatment methods used against it are around a century old. This is leading to more and more cases of recurrent urinary infections, which cause discomfort to those who suffer from them and which can even become a serious problem with the progression of the infections. antibiotic resistance.
Aware of this problem, a team of scientists from University College London has carried out a study aimed at checking why conventional methods do not solve the problems of urinary infections. To do this, they have developed a artificial bladder in which they have studied how the bacteria that cause infections interact with it.
This has allowed them to find some of their weak points and point out what the path should be to prevent recurrent urine infection. Now, it remains for other scientists to want to follow that path and, finally, a century later, take measures to combat a disease that, to no one’s surprise, mostly affects women.
The ins and outs of the urinary bladder and urine infection
It defines as a urine infection, which occurs when some bacteria colonize the urethra and, through the urinary tract, infect the organs associated with this system. The most common urine infection is cystitisin which the infected organ is the bladder.
That’s why, These scientists developed a three-dimensional model, based on the culture of bladder cells, in an environment that mimics that of the urinary tract. It could be said, therefore, that they developed a artificial bladder.
Once this first step was completed, they put the artificial bladder in contact with several bacterial species that are usually related to urinary infection: Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, Proteus mirabilis, Streptococcus agalactiae and Klebsiella pneumoniae.
In this way, they saw that not only do they proliferate very well in the urinary system environment, are also capable of developing very effective methods to evade both antibiotics and the immune system. They achieve this by adhering to the walls of the bladder, forming sheath-shaped structures.
This is done by both the beneficial bacteria of the genitourinary microbiota such as pathogens, causing urinary infection. And this is where we find the problems of traditional treatment and diagnosis.
Too old methods for a very current disease
Urinary infection is usually diagnosed with strips that are introduced into a sample and, through color changes, indicate the presence of parameters associated with the infection, such as proteins, blood or lymphocytes that come to fight the bacteria.
It also can culture urine in the laboratory looking for bacteria. This takes more time; but, logically, it gives more reliable results. Once these results are obtained, antibiotic treatment is resorted to, available since Alexander Fleming’s discovery, almost a century ago.
Traditionally, a broad-spectrum antibiotic has been used, called fosfomycin, which in two or three doses ended the infection. The problem is that there are more and more bacteria resistant to it, so we must go trying other antibiotics. Either way, there are no other options. It is true that some dietary supplements, such as cranberry, promise to prevent and treat urinary infections. However, there is no evidence that they are actually effective.
Therefore, we have a test that is based on culturing the urine or analyzing it with a strip. If bacteria have adhered to the bladder walls, very few will be detected in urine, so false negatives could occur. This is even more remarkable when patients drink plenty of water to reduce the discomfort of urine infection. The sample is more diluted, making it difficult hunt bacteria that have escaped from the bladder walls.
As for treatment, what antibiotics do is simply kill flies with cannon shots. It uses a broad spectrum antibiotic that attacks these bacteria and possibly many others, including the beneficial ones in the microbiota. Therefore, it is sometimes not uncommon for another type of infection to occur after treatment for a urinary infection. And, if that weren’t enough, antibiotics can have problems accessing the walls of the bladder. Therefore, the cannon shots would not even be pointing in the proper direction.
We should look at how our body reacts
The authors of this study have also seen that, by putting the artificial bladder in contact with the bacteria, the immune system It is capable of generating defenses against pathogens. But not against the harmless ones. Therefore, they propose that, in the event of a urine infection, diagnostic methods be developed based on the reaction of the immune system. This may indicate whether there are harmful bacteria hidden in the walls of the bladder.
In addition, logically, they propose the development of drugs designed to pass through the bladder tissues. An antibiotic for orally may not be enough.
After a century, it is time to innovate. And also to ask yourself a question. Would there have been innovation if urine infection were as common in men as it is in women?