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Pathogens 2016, 5(3), 52; doi:10.3390/pathogens5030052

Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI

Department of Microbiology, Immunology and Glycobiology (MIG), Institute of Laboratory Medicine, Lund University, 221 00 Lund, Sweden
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Author to whom correspondence should be addressed.
Academic Editor: Lawrence S. Young
Received: 12 November 2015 / Revised: 19 July 2016 / Accepted: 21 July 2016 / Published: 29 July 2016
(This article belongs to the Special Issue Molecular Aspects of Urinary Tract Infection)
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Abstract

We have established a novel strategy to reduce the risk for recurrent urinary tract infection (UTI), where rapidly increasing antibiotic resistance poses a major threat. Epidemiologic studies have demonstrated that asymptomatic bacteriuria (ABU) protects the host against symptomatic infections with more virulent strains. To mimic this protective effect, we deliberately establish ABU in UTI-prone patients, who are refractory to conventional therapy. The patients are inoculated with Escherichia coli (E. coli) 83972, now widely used as a prototype ABU strain. Therapeutic efficacy has been demonstrated in a placebo-controlled trial, supporting the feasibility of using E. coli 83972 as a tool to prevent recurrent UTI and, potentially, to outcompete antibiotic-resistant strains from the human urinary tract. In addition, the human inoculation protocol offers unique opportunities to study host-parasite interaction in vivo in the human urinary tract. Here, we review the clinical evidence for protection using this approach as well as some molecular insights into the pathogenesis of UTI that have been gained during these studies. View Full-Text
Keywords: asymptomatic bacteriuria (ABU); therapeutic efficacy; virulence asymptomatic bacteriuria (ABU); therapeutic efficacy; virulence
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Wullt, B.; Svanborg, C. Deliberate Establishment of Asymptomatic Bacteriuria—A Novel Strategy to Prevent Recurrent UTI. Pathogens 2016, 5, 52.

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