Sunday, March 16, 2008

Recurrent urinary tract infections

Phone calls in the night are a surefire way to set my heart racing. Death, destruction...or a patient with a urinary tract infection? I try to be understanding at 2 a.m., and heaven knows I do understand the agony of dysuria, that urgent, can't-be-quenched, fire of an infected bladder that sends a woman back and forth to the bathroom. And all too often, the middle-of-the-night episode is just one in a series of pesky infections.

What's up with recurrent urinary tract infections (UTIs)? Similarly plagued St. Louis rodents are providing clues as to why some UTIs are so hard to beat.
Washington University researchers induced UTIs in a group of volunteered rodents down at the lab. The rest reads like a science fiction story.

As expected, the e. coli bacteria invaded the epithelial cells lining the mousy bladders. Once inside the cells, the microbes set up housekeeping, forming a "biofilm" around themselves and their offspring. This protein shell protected them against attack from both antibiotics and the mouse's immune system. The growing colonies of bacteria, encased in their armor of protein, formed pods that pooched out from the bladder wall into the cavity of the bladder. Occasionally, the pods ruptured and spilled bacteria into the urine, thus creating another round of midnight misery for the mice. The Washington investigators theorize that if humans also experience attacks from the bacterial pod people, this would explain the recurrence of some UTIs after treatment.

And why my phone rings in the wee hours of the day.


JeanMac said...

Mercy, you have the patience of a saint. I`ve had one bladder infection but would never call in the night- bad enough I was running bed to toilet all night- why wake someone else -

Ruth said...

I am surprised by how many people have urinary retention. So many elderly people are admitted to our unit with delerium/falls related to UTIs. Most of them have high bladder residuals. Our doctor wouldn't answer the phone at 2AM for sure! (But you can call a Telehealth nurse for advice 24 hours a day.)

Cilicious said...

Good thing I swim regularly! :)

herbal remedy said...

Very interesting findings from the research. Taking cues from the bladder misery of rodents, a regular round of antibiotics then won't suffice to stop UTIs from recurring and this would only weaken the body's immune defenses in the long run. Natural remedies perhaps can be a milder (and effective) alternative to antibiotics. How to penetrate the protein cells created by the e-coli is something to think about though.