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Bacteria May Form 'Communities' in Bladder Cells

Human bladder infections may follow path seen in mouse model, with bacteria lurking in niches

THURSDAY, Dec. 20 (HealthDay News) -- Bladder infections in some women may follow a pathway recently demonstrated in mice, with bacteria invading epithelial cells and forming intracellular bacterial communities that could serve as reservoirs for recurrent infections, according to research published online Dec. 18 in PLoS Medicine.

David A. Rosen, of the Washington University School of Medicine in St. Louis, and colleagues analyzed midstream, clean-catch urine specimens from 80 young women with acute cystitis and 20 asymptomatic women with a history of urinary tract infections.

The researchers found signs of intracellular bacterial communities (IBCs) in 18 percent of the samples from women with active infections, and filamentous bacteria in 41 percent. They found these in none of the samples from the asymptomatic group. Of the 65 samples from patients with E. coli infections, they found IBC evidence in 22 percent and filamentous bacteria in 45 percent, but none in samples from women with gram-positive infections. In the mouse model, some cells containing biofilm-like IBCs are sloughed off into urine, and some form filaments that infect other cells.

"There are numerous implications of these findings for the pathogenesis of urinary tract infections, and for the possible treatment options available to prevent recurrent infection in UTI-prone women," writes Steven M. Opal, M.D., of Brown University in Rhode Island, in an accompanying article. "The findings of Rosen et al raise the intriguing possibility that detection of these relatively quiescent IBCs might help identify patients who may benefit from a longer course of antimicrobial agents, or from agents that penetrate the intracellular space."

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