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Virulent and multiresistant strains of Escherichia coli can develop in women's gut even without any symptoms, reveals a new study.
A team of health science researchers from the University of Washington and UW Medicine found that 8.8% of healthy women with no apparent symptoms of urinary tract infections were carriers of the disease. superbug, Escherichia coli strains in their gut.
Three-dimensional illustration of Escherichia coli bacteria. Image credit: Kateryna Kon / Shutterstock
Women more prone to urinary tract infections (UTIs)
The study, published in the journal Clinical Infectious Diseases, showed that the pathogen responsible for the disease can be transferred from a woman's gastrointestinal tract to her urinary tract through the lymphadenopathy. urethra and the urinary cbad.
The urinary tract of women is relatively shorter than that of men, making them vulnerable to urinary tract infections. Bacteria can reach the bladder and other parts of the urinary tract.
Escherichia coli is the most common causative agent of urinary tract infection in women, causing cystitis or inflammation of the bladder. This bacterium is commonly found in the gastrointestinal tract, but the team found that the multidrug-resistant strain was also in the intestine.
Multidrug-resistant strains found in human stool
To achieve their results, researchers badyzed data from more than 1,000 healthy women, who show no symptoms of urinary tract infection. They found that fluoroquinolone resistant Escherichia coli feces of 8.8% of healthy women, most of the pathogens belonging to the multidrug-resistant strain, ST1193 or STI131-HClonal groups 30R.
The ST1193 or STI131-HClonal 30R groups are the cause of most urinary tract infections and drug-resistant bloodstream. Clonal clusters of superbugs were also detected twice as often in the urine of patients who had them in the intestine.
In addition, those who had a bowel resistant to fluoroquinolone (Cipro) Escherichia coli gave urine samples. More than a third of them had a positive test of Escherichia coli and among these, approximately 77% were resistant to Cipro and the bacterial clonal type corresponded to the faecal sample.
No history of antibiotic use
The researchers also investigated whether patients could have taken an antibiotic during the study for an infection in the body. They found that these women were not taking antibiotics and that they had no symptoms.
Three months after the urine collection, 7% of the 45 previously asymptomatic persons developed a urinary tract infection.
"The two pathogenic strains of the urinary tract resistant to pandemic fluoroquinolone Escherichia coli found in clinical specimens are superior intestinal colonizers and tend to persist there, "the authors wrote.
"They may also appear, at an unusually high rate, in the urine of healthy women who had not received a documented diagnosis of urinary tract infection at the time of badysis." of the sample. Both phenomena seem to be interconnected, "they added.
Clinical care and implications for infection control
Previously, it was known that most urinary tract infections developed when bacteria in the intestine cleared their way into the urethra and ureters, into the bladder. However, there is emerging evidence that healthy women can harbor strains of multidrug-resistant pathogens.
The study has many implications in terms of clinical care and infection control. The results can help prevent urinary tract infections and formulate new therapeutic approaches to fight superbugs. Being able to detect whether a healthy woman has multidrug-resistant, virulent bacteria in the gut can reduce the prevalence of multidrug-resistant infections in healthy, non-symptomatic women.
In addition, preventive measures can reduce the risk of transmission of the virus by carriers to other members of the household.
The researchers point out that being able to determine a woman's carrier status can help predict future resistant infections and devise preventative measures to reduce the onset of infection.
The most commonly prescribed drugs for urinary tract infections are fluoroquinolones, but some strains have become increasingly resistant to these drugs. Although efforts have been made to limit the use of these drugs, the rate of multidrug-resistant infections is spreading around the world.
The superbugs, ST119 and ST131-H30R, which has been established in the intestine for long periods of time without being detected and without any symptoms, may have contributed to its spread throughout the world.
Journal reference:
V. Tchesnokova, E., E. Chanh, H., H. Ghirmai, L., L., Ferrier, K., D. Schroeder, T., T. Solyanik, K., Hansen, K., Ralston, J., K. Riddell, D. Scholes and E. Sokurenko (2019). Escherichia coli resistant to fluoroquinolone and pandemic uropathy have an increased ability to persist in the intestine and cause bacteriuria in healthy women. Clinical infectious diseases. https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciz547/5528138?redirectedFrom=fulltext
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