Journal
INFECTION AND IMMUNITY
Volume 70, Issue 12, Pages 7042-7049Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/IAI.70.12.7042-7049.2002
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Funding
- NIAID NIH HHS [R01AI48689, R01 AI048689] Funding Source: Medline
- NIDDK NIH HHS [R01 DK051406, R21DK57926, R21DK57936, R01DK51406] Funding Source: Medline
- PHS HHS [R01A129549] Funding Source: Medline
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One of the more perplexing aspects of urinary tract infections (UTIs) is their high propensity to recur. It has been proposed that recurrent infections are a result of the reintroduction of bacteria from the gastrointestinal tract (GIT) to the urinary tract (UT); however, since a significant subset of recurrent UTIs are caused by an identical bacterial strain, it has been challenging to formally prove this hypothesis for same-strain recurrences by using epidemiologic approaches. We present data here obtained by using a mouse model of UTIs in which it was shown that 36% (5 of 14) of mice infected with uropathogenic Escherichia coli (UPEC) will have at least one bacteriuric recurrence, with 21% (3 of 14) having more than one recurrence during a 6-week period after an acute UTI. Intraurethrally infected mice develop UPEC reservoirs in both their feces and their bladders. Ten days of trimethoprim-sulfamethoxazole (SXT) therapy reduces urinary recurrences and eradicates fecal colonization, whereas 3 days of SXT treatment has no effect over a twenty-eight-day observation period despite clearing fecal colonization acutely. Interestingly, SXT is unable to eradicate bacteria from the bladder reservoir even after a 10-day treatment regimen, thus demonstrating that the bladder reservoir can persist even in the face of long-term antibiotic therapy.
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