Nonantibiotic prevention and management of recurrent urinary tract infection

Sihra, Néha; Goodman, Anna; Zakri, Rhana Hassan; Sahai, Amit; Malde, Sachin

doi:10.1038/s41585-018-0106-x

Cited by 209 publications

(207 citation statements)

References 206 publications

Supporting

Mentioning

157

Contrasting

Unclassified

Order By: Relevance

“…Besides the fiscal impact, the frequent use of antimicrobials in these patients contributes to the worrisome trend of increasing antimicrobial resistance as well as the morbidity caused by adverse drug effects. Not surprisingly, several therapeutic agents beyond antimicrobials are being trialled for treating recurrent UTI, although with mixed success [8].…”

Section: Introductionmentioning

confidence: 99%

“…The EAU guidelines mention SH as a valuable and beneficial agent, though acknowledging that the evidence in favour of its use is low-powered and that more research is needed [3]. Currently, there is limited literature describing patient-reported outcomes and QoL after treatment with intravesical SH, and studies examining these aspects of care are needed to help define the role of SH as a treatment option [8].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Intravesical sodium hyaluronate reduces severity, frequency and improves quality of life in recurrent UTI

et al. 2019

View full text Add to dashboard Cite

Purpose Urinary tract infections (UTI) occur in nearly half of all women at least once, with around 35% experiencing recurrences. Bladder mucosal glycosaminoglycan (GAG) layer damage is postulated to contribute. Sodium hyaluronate (SH) replenishes the GAG layer and is believed to be protective. However, there is limited literature on patient-reported outcomes and quality of life (QoL) after treatment. Our objective was to observe changes in UTI severity and QoL after treatment with intravesical SH. Methods In this retrospective, observational patient-reported outcome study, we examined outcomes in UTI patients treated with intravesical SH. SH was instilled weekly for 6 weeks. If symptoms persisted, patients received further instillations on demand. Patients were sent postal questionnaires to score symptoms before and after treatment. Patient-reported UTI occurrences before treatment were compared with recurrences after treatment collected from their primary care providers. Results There were 18 (58.1%) valid replies. The median age was 75. The median duration of illness before treatment was 4.5 (IQR 2.8-7) years. The median number of infections fell from ten per year (IQR 7-10) before treatment to two per year (IQR 0-5) after treatment. Pain improved by 34%, urgency 30%, nocturia 30%, frequency 32%, 'inability to carry out daily activities due to UTI related ill-health' 37% and 'loss of sleep' by 38%. Patients reported a 76% improvement in 'UTI-related QoL.' No adverse events were reported. Conclusion SH is safe and useful for managing patients with recurrent UTI, with improvements in symptoms, QoL, a decrease in the number of UTI episodes and in the best interests of antimicrobial stewardship.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

show abstract

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Intravesical sodium hyaluronate reduces severity, frequency and improves quality of life in recurrent UTI

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Different Foley catheter lock solutions were previously tested, for example ethanol, minocycline alone or in combination with EDTA (Raad et al ) and N‐acetylcysteine (Marchese et al ). Recently, due to the emergence of resistant micro‐organisms to commonly used antibiotics, nonantibiotic antimicrobials and alternative methods to antimicrobial treatments are gaining popularity as promising methods to control infections (Rosenblatt et al ; Noeltinget et al ; Sihra et al ).…”

Section: Introductionmentioning

confidence: 99%

Antibiofilm properties of triclosan with EDTA or cranberry as Foley Catheter lock solutions

et al. 2019

View full text Add to dashboard Cite

Aims To investigate the efficiency of triclosan, ethylenediaminetetraacetic acid (EDTA) and cranberry alone or in combinations against Escherichia coli strains as urinary catheter lock solutions to reduce catheter‐associated urinary tract infections. Methods and Results Viable counting was used to assess antibiofilm activities for triclosan, EDTA and cranberry alone or in combinations against E. coli strains embedded in biofilm onto all‐silicon Foley catheter surface. The results revealed that combination of triclosan (10 mg ml−1/EDTA 30 mg ml−1) when filling the catheter balloon was able to eradicate and prevent biofilm formation among all tested E. coli including the resistant strains, whereas triclosan (8·5 mg ml−1)/ cranberry (103 mg ml−1) combination was a successful catheter lock solution by preventing all tested strains from adhering onto catheter surface when filled via the eye hole. Conclusions The combinations of triclosan/EDTA and triclosan/cranberry were significantly effective in eradicating and preventing biofilm formation of the tested E. coli strains on Foley catheters. Significance and Impact of the Study Combinations of triclosan/EDTA and triclosan/cranberry have a promising application as nonantibiotic catheter lock solution.

show abstract

“…A high incidence of recurrence and frequent progression to chronic condition exacerbates the negative impact of UTIs on patients’ quality of life and healthcare costs (2). Despite the magnitude of the problem, treatment remains limited by a strain’s susceptibility to available antibiotics, which are often ineffectual (3–5).…”

Section: Introductionmentioning

confidence: 99%

Genetically diverse uropathogenicEscherichia coliadopt a common transcriptional program in patients with urinary tract infections

Sintsova

Frick-Cheng

Smith

et al. 2019

Preprint

View full text Add to dashboard Cite

19Uropathogenic Escherichia coli (UPEC) is the major causative agent of 20 uncomplicated urinary tract infections (UTIs). A common virulence genotype of UPEC 21 strains responsible for UTIs is yet to be defined, due to the large variation of virulence 22 factors observed in UPEC strains. We hypothesized that studying UPEC functional 23 responses in patients might reveal universal UPEC features that enable pathogenesis. 24Here we identify a transcriptional program shared by genetically diverse UPEC strains 25 isolated from 14 patients during uncomplicated UTIs. Strikingly, this in vivo gene 26 expression program is marked by upregulation of translational machinery, providing a 27 mechanism for the rapid growth within the host. Our analysis indicates that switching to a 28 more specialized catabolism and scavenging lifestyle in the host allows for the increased 29 translational output. Our study identifies a common transcriptional program underlying 30UTIs and illuminates the molecular underpinnings that likely facilitate the fast growth 31 rate of UPEC in infected patients. 32 33 129 UPEC show increased expression of replication and translation machinery during 130 UTI. Differential expression analysis of the infection and in vitro transcriptomes 131identified 492 differentially expressed genes (log 2 fold change greater than 2 or less than 132 -2, adjusted p values < 0.05) (Fig. 3A, Dataset S3, S4). Interestingly, pathway analysis 133 and manual curation of the differentially expressed gene list revealed that expression of 134 ribosomal subunits (r-proteins), and enzymes involved in rRNA, tRNA modification, 135 purine and pyrimidine metabolism, are significantly higher in patients compared to in 136

show abstract

Nonantibiotic prevention and management of recurrent urinary tract infection

Cited by 209 publications

References 206 publications

Intravesical sodium hyaluronate reduces severity, frequency and improves quality of life in recurrent UTI

Intravesical sodium hyaluronate reduces severity, frequency and improves quality of life in recurrent UTI

Antibiofilm properties of triclosan with EDTA or cranberry as Foley Catheter lock solutions

Genetically diverse uropathogenicEscherichia coliadopt a common transcriptional program in patients with urinary tract infections

Contact Info

Product

Resources

About