Effect of antibiotic treatment on receptivity of uroepithelial cells to uropathogens

Can J Microbiol. 1988 Mar;34(3):327-31. doi: 10.1139/m88-060.

Abstract

The management of female patients with recurrent urinary tract infections still remains a problem, and long-term prophylactic or short intermittent courses of antibiotics are the standard forms of therapy. In this report, 10 patients were examined for the effects of long- and short-term treatment with trimethoprim-sulfamethoxazole (TMP-SMX) antibiotics on the receptivity of uroepithelial cells to bacterial adherence. The urine of all patients was sterile while on antibiotic therapy. Few bacteria were found adherent to the cells from adult patients (group 1, mean age 36 years) on long-term antibiotics, but the cells were highly receptive to uropathogens in vitro, especially for Escherichia coli expressing mannose-resistant adhesins. Controls of age-matched adult females were included and in vitro adherence levels were found to be higher for those women with a history of urinary tract infection compared with those with no past record of infection. In the second group, elderly patients (mean age 87 years) presented with bacteriuria, and their uroepithelial cells were found to be colonized by uropathogens to a significantly greater extent than their controls. The adherent population was reduced during 7-day TMP-SMX antibiotic treatment, but increased posttherapy, particularly in two patients who subsequently became reinfected. The in vitro results showed that uroepithelial cells retain their receptivity to uropathogenic adherence, both during and after treatment. Although antibiotics eradicate uropathogens from the urinary tract, patients remain susceptible to recolonization by uropathogens and are at risk of reinfection after completion of therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Urinary / pharmacology
  • Anti-Infective Agents, Urinary / therapeutic use*
  • Bacterial Adhesion / drug effects*
  • Cells, Cultured
  • Drug Combinations / pharmacology
  • Drug Combinations / therapeutic use
  • Epithelium / drug effects
  • Epithelium / microbiology
  • Female
  • Humans
  • Recurrence
  • Sulfamethoxazole / pharmacology
  • Sulfamethoxazole / therapeutic use*
  • Trimethoprim / pharmacology
  • Trimethoprim / therapeutic use*
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Urinary Tract / drug effects
  • Urinary Tract / microbiology*
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Infective Agents, Urinary
  • Drug Combinations
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Trimethoprim
  • Sulfamethoxazole