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A recent study of more than 1,000 healthy women with no symptoms of urinary tract infections showed that nearly 9% had multidrug-resistant strains of Escherichia coli in their belly.
This is a clinical concern because the disease causing E. coli Bacteria can pbad from the gastrointestinal tract to the female urinary tract via the urethra, the urinary tract, which is shorter and positioned differently in women than in men. The bacteria can then enter the bladder and other parts of the urinary tract.
More than one-third of the urine samples provided by those who had a fluoroquinolone-resistant (Cipro) -resistant digestive tract E. coli tested positive for E. coli growth. Of these, nearly 77% were resistant to Cipro and the clonal type of the bacteria matched the fecal sample.
Most pathogens E. coli found to belong to the multidrug-resistant ST131-H30R or ST1193 clonal groups that currently cause the majority of urinary tract and drug-resistant bloodstream infections. They were detected twice as often in the urine of people with these strains in the intestine, compared to other strains of E. coli in general.
In addition, the presence of ST ST131-H30R in the gut in this study was badociated with older age.
The researchers also verified which participants had possibly received a prescription for antibiotics during the study for any type of infection, including respiratory.
Three months after this urine collection, urinary tract infections were diagnosed in almost 7% of the 45 previously asymptomatic carriers who consented to the follow-up examination of the electronic medical record. Participants in the study came from the Puget Sound area.
"The two pathogenic strains of the urinary tract resistant to pandemic fluoroquinolone E. coli discovered in clinical specimens are higher intestinal colonizers and tend to persist there, "the researchers noted. They may also appear, at an unusually high rate, in the urine of healthy women who did not have a documented diagnosis at the time of the sample test. Both phenomena seem to be interconnected.
The researchers pointed out that it has long been known that a patient's microbial flora often hosts strains causing urinary tract infection. It was not certain that pandemic drug-resistant strains have distinct mooring patterns in the gut or lower urinary tract of healthy people.
The study was published in the Oxford University Press, Clinical Infectious Diseases.
The findings could have several implications in terms of clinical care and infection control, according to Evgeni V. Sokurenko, a professor of microbiology at the University of Washington's School of Medicine. He was the principal investigator of the study. Several other microbiology professors from UW and researchers from the Kaiser Permanent Research Institute in Seattle have collaborated on this work. The principal investigator was Veronika L. Tchesnokova, Department of Microbiology, Faculty of Medicine, University of Medicine.
Results suggest multidrug-resistant specificity E. coli the strains detected in this study have a much longer residence in the intestine than some other resistant strains, and can also become present in the urine of healthy women without causing burns, emergency , blood in the urine or other warning signs of a bacterial infection.
Sokurenko explained that whether multidrug-resistant strains are present in a woman's intestine could help predict the resistance pattern of a subsequent clinical infection. Efforts to get rid of the pandemic E. coli Strains in the intestine of carriers could reduce their rate of multidrug-resistant infections to medications, and possibly protect their household or other contacts as well.
Sokourenko also said the drugs may need to reexamine the clinical significance of the discovery of bacteria in the urine, even without symptoms, during this pandemic of multiple antibiotic resistant strains. E. colibecause these strains could expose carriers to a bacterial disease that is difficult to treat.
Fluoroquinolones are the most commonly prescribed drugs for urinary tract infections. Despite efforts to limit its use, strains resistant to this clbad of antibiotics are in full swing and are spreading worldwide, according to researchers.
The superior ability of the two pandemic strains, ST131-H30R and ST119, to settle permanently in the belly of the population may have contributed to their rapid global spread, said the researcher. They can be maintained and transmitted in healthy individuals even in the absence of the use of antibiotics, which can disrupt the microbial composition of the intestinal flora.
The researchers concluded that this study highlights the likely physiological reasons for the pandemic of these resistant bacteria. E. coli strains. It also emphasizes the value of determining the carrier status of patients to predict future resistant infections, and the need to rethink the clinical significance of bacteria present in the urine without symptoms, d & # 39; as much as these pandemic strains can be superbugs: highly pathogenic. to the urinary system and resistant to treatment.
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