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The Medical Bond: An entirely new way to attack urinary tract infections (UTIs)

New Contributor III
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In a recent paper I saw in ACS’ Journal of Medicinal Chemistry, one research group is taking a very different and, might I add, clever approach to fighting off urinary tract infections, or UTIs. Surprisingly, it doesn’t involve the use of traditional antibiotics. That’s important because overuse of these drugs can lead to resistant bacteria, or “superbugs” that shrug off some of the most powerful new antibiotics. Thus, this new potential treatment wouldn’t contribute to the rise of additional difficult-to-treat superbugs.

About 8.1 million men and women go to their general practice doctor or urologist every year in the U.S. because of a UTI, which is one of the most common types of infections. In 2007, about half a million people actually had to visit the hospital because of them. Women are more prone to these infections, as their urethras are shorter, giving bacteria easy, quick access to the bladder. Patients who use catheters, or tubes, in order to remove urine from the body also are at a high risk for developing painful UTIs. UTIs cause burning and pain when using the bathroom and sometimes results in smelly, discolored urine or back pain.

These infections are most often caused by bacteria, such as E. coli, so the traditional treatment is a course of antibiotics. UTIs often recur, though, and repeated courses of antibiotics could lead to resistant strains.

Because many bacteria are becoming superbugs, Beat Ernst and colleagues decided to try a brand-new approach — developing substances that target “bacteria virulence factors.” That is, instead of killing the bacteria outright, the researchers interfere with how the bacteria latch onto bladder cells. The thinking is that if the bacteria can’t attach to the cells, they can’t infect them, and the bacteria just get washed away in the urine. The researchers expect that this new class of drugs will have a greatly reduced chance of leading to resistance.

The scientists go on to describe the development of “anti-adhesion molecules” that specifically get in the way of the bacterial attachment. The best-performing substance, called an indolinylphenyl mannoside, prevented a UTI from developing in mice (stand-ins for humans in this kind of experiment) for more than eight hours. In the study, a very low dose reduced the amount of bacteria in the bladder of the animals by almost 10,000 times, which is comparable to the standard antibiotic treatment with ciprofloxacin.

Can you envision other ways of stopping bacterial infections? Do you think this strategy could work with other microbes, like fungi and viruses?

“Antiadhesion Therapy for Urinary Tract Infections—A Balanced PK/PD Profile Proved To Be Key for Suc...


Credit: Centers for Disease Control and Prevention