Urodynamic Factors Influence the Duration of Escherichia Coli Bacteriuria in Deliberately Colonized Cases

Wullt, Björn; Connell, Hugh; Röllano, Piotr; Månsson, Wiking; Colleen, S.; Svanborg, Catharina

doi:10.1016/s0022-5347(01)63246-4

Cited by 63 publications

(53 citation statements)

References 21 publications

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“…Alternatively, commensal strains may be able to persist in the neurogenic bladder due to the presence of residual urine and compromised bladder function. Wullt et al 15 inoculated, E. coli strain 83972 isolated from a patient with asymptomatic bacteriuria, into the bladder of 16 adults with recurrent UTI. E. coli 83972 possesses several virulence genes but does not express any.…”

Section: Discussionmentioning

confidence: 99%

Escherichia coli colonizing the neurogenic bladder are similar to widespread clones causing disease in patients with normal bladder function

et al. 2008

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Study design: Clonal typing of neurogenic clones. Objective: To determine whether neurogenic clones carried over weeks in the urine of asymptomatic children with neurogenic bladder were similar to known uropathogenic clones associated with disease. Setting: Michigan State University; VA Medical Center, Minneapolis, MN, USA. Methods: Escherichia coli isolates from the urine of 15 children previously followed were typed by multilocus sequence typing and compared to 2 human pyelonephritis genome strains, 29 pediatric or adult symptomatic urinary tract infection strains, 15 pediatric asymptomatic bacteriuria strains, 6 animal urinary tract infection strains and a neonatal meningitis-septicemia prototype K1 strain. Phylotypes and virulence genotypes were determined using PCR. Results: Twenty-nine E. coli isolates were classified into 15 clones. Six of 15 clones were the same sequence type or a close relative to a clone that caused disease in a human or animal. These clones were considered uropathogens. The remaining nine clones were not closely related to a clone that caused disease and were considered commensal clones. Uropathogens were predominantly group B2, exhibited more virulence genes and were carried for more weeks in the neurogenic bladder compared to commensal clones. Nine of 15 children carried one or more uropathogenic clones; 4 children carried one or more commensal clones and 2 children carried both uropathogenic and commensal clones. Conclusion: Children with neurogenic bladder most commonly carried commensal clones. Uropathogenic clones were associated with prolonged carriage, however, carriage was not associated with symptomatic disease or deterioration of the upper urinary tract.

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Section: Discussionmentioning

confidence: 99%

Escherichia coli colonizing the neurogenic bladder are similar to widespread clones causing disease in patients with normal bladder function

et al. 2008

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“…11 In a pilot study in spinal cord injury patients, Darouiche et al 6 performed a double-blind, randomized prospective study with 40 patients either receiving a 3-day oral course of ciprofloxacin or placebo. No patient who received ciprofloxacin developed symptomatic UTI compared with three of 22 (14%) subjects randomized to the placebo group; the protective efficacy of antibiotic prophylaxis however did not attain statistical significance.…”

Section: Abbreviation: Uti Urinary Tract Infectionmentioning

confidence: 99%

Morbidity of urodynamic testing in patients with spinal cord injury: is antibiotic prophylaxis necessary?

Pannek

Nehiba

2007

Spinal Cord

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Study Design: Prospective, non-randomized study. Objectives: To assess the incidence of urinary tract infection after urodynamics in patients with spinal cord injury. Setting: Outpatient clinic of a university hospital in Germany. Methods: Urinary tract infection and clinical symptoms in 109 consecutive outpatients with spinal cord injury following urodynamic evaluation were studied. Results: Data from 72 patients were evaluable. Of these, seven patients (9.7%) developed a significant urinary tract infection. Five of these were symptomatic. Pre-existing asymptomatic bacteriuria was not associated with a higher risk for post-interventional infection. The technique of the bladder management did not correlate with urinary tract infection rates. Conclusion: In this study, symptomatic urinary tract infections after cystometry were not infrequent. Therefore, it seems that antibiotic prophylaxis cannot be omitted in patients with spinal cord injury undergoing urodynamic investigation.

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“…> 30 days) colonisation may be due largely to the fact that the dogs had an ostensibly normal urinary tract anatomy and function. Humans with normal bladder function also prove very difficult to colonise (Wullt et al, 1998). In addition, protocols for colonisation in humans generally involve a multi-dose protocol with inoculation occurring two to three times daily for three days Darouiche et al, 2001Darouiche et al, , 2005.…”

Section: Discussionmentioning

confidence: 99%

“…Deliberate colonisation with E. coli 83972 was also attempted in 16 patients with refractory recurrent urinary tract infection (12 with neurogenic bladder disorders) in order to evaluate the effect of urodynamic factors on success of colonisation (Wullt et al, 1998). Six of 12 patients with neurogenic bladder disorders were colonised long term (5 months to 2 years) and three became short-term carriers in comparison to minimal success in four patients with normal bladder function (one was colonised for 7 days).…”

Section: Clinical Work With E Coli 83972mentioning

confidence: 99%

“…The strain is well adapted for growth in the human urinary tract and long-term asymptomatic bacteriuria (ASB) has been established in humans by inoculation via a urinary catheter (Andersson et al, 1991;Wullt et al, 1998Wullt et al, , 2000Darouiche et al, 2001Darouiche et al, , 2005. Deliberate colonisation of human patients with E. coli 83972 fails to induce a host inflammatory response and this is associated with the attenuation of several virulence determinants including type 1, P and F1C fimbriae (Wullt et al, 2000;Klemm et al, 2006;Roos et al, 2006a).…”

Section: Introductionmentioning

confidence: 99%

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Preventing canine urinary tract infection (UTI) using an asymptomatic bacteriuria (ASB) Escherichia coli strain

Thompson¹

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Bacterial cystitis occurs with reasonable frequency in dogs. Persistent infection and repeated reinfection (recurrent bacterial urinary tract infection, hereafter termed recurrent UTI) is reported less frequently. Recurrent urinary tract infection is predominantly diagnosed in dogs with a predisposing or comorbid condition, and episodes are often subclinical. Escherichia coli is the most frequently cultured species in both uncomplicated bacterial cystitis and recurrent UTI.Antimicrobial therapy limitations and global emergence of bacterial strains that are both virulent and multidrug-resistant (MDR) has led to an urgent requirement for novel control strategies in both companion animals and humans. Escherichia coli strain 83972 has been successfully used to colonise the bladder of humans with recurrent UTI in order to reduce the incidence of subsequent febrile UTI via the process of active bacterial interference. This strategy has not been utilised in dogs to date but may prove an effective alternative to antimicrobial therapy if it can be shown to colonise the bladder of dogs safely and effectively compete with uropathogens.A retrospective study to examine the signalment, infecting strains, presence of clinical signs, and incidence of pyuria in Australian dogs with recurrent urinary tract infection was performed. The findings were similar to those of two large North-American studies with regard to signalment, predisposing or comorbid diseases, bacterial species isolated, and resistance to commonly used oral antimicrobials, although the median age of our dogs was higher at 10 years (7 years in both prior studies). Examination of the E. coli isolates from a subset of nine dogs provided new information on phylogenetic group, virulence gene profiles, haemolytic phenotype, expression of type 1 fimbriae, and sequence type (ST). Phylogenetic groups F and B2 were frequently identified, representing 13/32 (41%) and 8/32 (25%) of isolates respectively, but no phylogroup B2 isolates were MDR, in comparison with phylogroup F isolates, which accounted for 12/16 (75%) MDR isolates. Clonal groups of global importance such as ST131-B2, ST354-F, ST38-D and ST457-F were represented, with possible implications for both companion animal and human health. Of particular concern was the repeated isolation of ST354-F strains from the urine of a paralysed dog over a 3-year period.When competition experiments between E. coli 83972 and a selection of canine uropathogenic E. coli (UPEC), including emerging, highly virulent MDR strains with zoonotic potential, were performed in pooled canine urine, E. coli 83972 was largely non-competitive against the canine isolates after 17 hr of incubation. This finding contrasted with the competitive superiority previously exhibited by E. coli 83972 in pooled human urine in competition experiments with human UPEC strains. In 5/10 trials, the E. coli 83972 was not outcompeted in canine urine, iii however, and given that the starting ratio in dogs following prophylactic bladder colonisation would ...

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Urodynamic Factors Influence the Duration of Escherichia Coli Bacteriuria in Deliberately Colonized Cases

Abstract: E. coli 83972 bacteriuria could only be established in a subset of patients with defective bladder voiding, suggesting that urodynamic defects permit a nonvirulent strain to establish in the urinary tract, but that additional host factors determine if bacteriuria will persist.

Cited by 63 publications

References 21 publications

Escherichia coli colonizing the neurogenic bladder are similar to widespread clones causing disease in patients with normal bladder function

Escherichia coli colonizing the neurogenic bladder are similar to widespread clones causing disease in patients with normal bladder function

Morbidity of urodynamic testing in patients with spinal cord injury: is antibiotic prophylaxis necessary?

Preventing canine urinary tract infection (UTI) using an asymptomatic bacteriuria (ASB) Escherichia coli strain

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