Bert Vorstman, MD,MS,FAAP,FRACS,FACS www.urologyweb.com
The latest issue of PLOS ONE reported that researchers may have found a method to assess the women at risk for developing a urinary tract infection (UTI) following pelvic-floor surgery.
Urinary tract infections (UTI), the most common type of bacterial infection, have estimated treatments costs exceeding USD$1 billion a year in the United States alone. Women who undergo surgery for pelvic-organ prolapsed or urinary incontinence are more likely to develop a UTI following the procedure. Due to a lack of effective methods to identify the risks, clinicians found it difficult to treat specific patients with an increased UTI risk in the past.
Findings found that certain urinary bacteria and antimicrobial peptides, which normally help the bladder immune system function, may identify women at increased risk for a UTI following pelvic-floor surgery.
“This information may help us improve UTI prevention and treatment strategies for women down the road,” said Katherine Radek, PhD, senior author, assistant professor, Department of Surgery and a member of Loyola’s Burn & Shock Trauma Research Institute.
Relationship between urinary bacteria, antimicrobial peptides and UTI symptom severity in 54 women undergoing pelvic-floor surgery were the focus of the study. Participants completed a questionnaire and provided a catheterized urine specimen obtained under anesthesia on the day of surgery. The urine was analysed using advanced DNA-based detection methods. Of these 54 women, 10 or 18.5% developed UTI symptoms after surgery while four or 7% had positive urine cultures after surgery. Thirteen participants, or 24% of the group, had positive urine cultures before surgery. The rest had negative urine cultures before surgery.
Researchers found that the diversity and abundance of specific urinary bacteria and the amount of a specific antimicrobial peptide were different in women who developed a UTI following surgery compared with those who did not: lower risk of post-operatvie UTI correlated with greater bacterial diversity, greater abundance of the Lactobacillus species and higher levels of the antimicrobial peptide β-defensin-1.
Further insight into the mechanisms by which bladder bacteria and antimicrobial peptides communicate during normal and disease states will facilitate the development of better prevention and/or treatment strategies for UTI-susceptible populations.
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