Why some women just can’t get rid of bladder infections

SCIENTISTS have discovered why some women repeatedly suffer debilitating bouts of cystitis.

Six out of ten women will have at least one urinary tract infection, or UTI, in their lifetime – but 25 per cent of these will have a repeat infection in the following six months.

Medical science had previously been at a loss to understand why they are more susceptible.

But now researchers have found that the bug that causes cystitis, a type of e.Coli bacteria, can ‘reprogramme’ the lining of the bladder. These changes to the bladder’s cells mean the bug can come back and strike more easily.

Experts warn that women could therefore face repeated bouts of the disease if they don’t get treatment rapidly.

The scientists say their new understanding of why the infections repeatedly strike could lead to a vaccine to protect those who repeatedly suffer the disease.

Researcher Valerie O’Brien of Washington University in St Louis said the reason for the repeat infections was poorly understood.

The disease was ‘a significant health, financial and quality of life burden worldwide’, she said.

The researchers found that there were two outcomes when mice were infected with the bacteria.

Either they resisted the infection after the first 14 days, or they suffered a persistent bladder infection. The key factor was whether the infection was treated with antibiotics.

If it was not treated within 14 days, the scientists found that this allowed time for the e. Coli to ‘ remodel’ the lining of the bladder.

This allowed the bugs to more easily multiply on the bladder wall, the research published in Nature Microbiology found.

The treated mice were ‘ highly resistant to challenge infection’, while those treated later were ‘sensitised’ and ‘ became predis- posed to developing severe recurrent cystitis’.

The bladders of the affected mice were ‘irreversibly altered’, but the researchers said the changes to the bladder wall meant that a vaccination could be developed to prevent repeat infections.

Tests in monkeys showed that the animals suffering repeated bladder infections could be treated with a vaccine which strengthened the altered cells in the bladder lin- ing that had been hijacked by the bacteria.

The authors say their study could reveal ‘vulnerabilities’ in the way the disease develops which could lead to new drug treatments.

Louise de Winter, chief executive of The Urology Foundation, a charity which is dedicated to combating UTIs, said: ‘UTIs are the bane of people’s lives. Most women will have at least one UTI during their lifetime and many will have repeated attacks. UTIs are painful and debilitating and can have a significant impact on a patient’s quality of life.

‘Any research that shows the potential to solve this problem that affects so many of us, in this instance potentially via a vaccine, is to be welcomed.

‘We need to wait and see what this research fully delivers but we welcome research in this area.’

Professor Christopher Fry, chairman in applied physiology and head of the School of Physiology and Pharmacology at the University of Bristol, added: ‘The message with UTIs is that they are very difficult to treat.

‘We know that they reoccur and are extremely uncomfortable.

‘What is novel about this research is that it has identified a way in which UTIs can reoccur and become resistant to conventional antibiotic treatment.

‘This gives a clue as to why they are so difficult to treat and reoccur so readily, leaving a residual effect that is not going to be tackled by conventional antibiotics.’

‘Painful and debilitating’