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8 UTI Home Remedies Other Than Antibiotics
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A urinary tract infection (UTI) can cause a range of symptoms and knock you off your feet. While antibiotics are the most effective treatment for a UTI, you can use these home remedies to help manage your symptoms.
A UTI can cause symptoms like bloody urine and pain in the lower abdomen or pelvic region.
These infections are responsible for roughly 8 million doctor visits each year. They're the second most common type of infection to occur in the human body, developing more often in women than men.
Wondering how to get rid of a UTI? Read on to learn about the research behind at-home and over-the-counter (OTC) treatments.
Until there are more advancements in UTI treatment, antibiotics remain the most effective standard treatment. If left untreated, UTIs can lead to serious complications and health problems.
Sometimes, antibiotics may become less effective over time, a phenomenon known as antibiotic resistance. In that case, work with a doctor on the best treatment plan for symptom relief.
In addition to antibiotics, some home remedies may help ease symptoms and prevent reoccurring infections.
Try cranberries Cranberries may contain an ingredient that stops bacteria from attaching to the walls of the urinary tract. Specifically, a 2023 study found that compounds called proanthocyanidins may prevent Escherichia coli (E. Coli) from binding with cells in the bladder. Though the existing body of evidence is inconclusive, some studies suggest that you might be able to reduce your risk of UTIs with cranberry products, including unsweetened cranberry juice, cranberry supplements, or dried cranberries. Other studies have noted that the use of cranberries to prevent UTIs doesn't produce consistent results, so more research is needed. If you're interested in trying cranberries to support urinary tract health, consider 365 by Whole Foods Market, Organic 100% Pure Cranberry Juice. This organic option contains no added sugar. Recommended products: Whole Foods Market Organic 100% Pure Cranberry Juice Spring Valley Cranberry Extract Capsules Whole Foods Market Organic 100% Pure Cranberry Juice Spring Valley Cranberry Extract Capsules
Drink plenty of water Although urinating can be painful when you have a UTI, it's important to drink as many fluids as possible — particularly water. Most adults should aim to drink between six and eight 8-ounce glasses of water per day. The more you drink, the more you'll urinate, which can help flush harmful bacteria from the urinary tract.
Pee when you need to Holding your urine or ignoring the urge to urinate can allow bacteria to multiply in your urinary tract. As a rule of thumb, always use the bathroom when you feel the urge. It's also important to make sure you're fully emptying your bladder when you urinate. As well, always make sure to urinate after sex, especially if you have a vagina. If you do, it's also important to wipe front to back after you urinate.
Take probiotics Probiotics promote healthy digestion and immunity. They also may be effective in treating and preventing UTIs when used alongside standard antibiotic therapy. With a UTI, bad bacteria replace good bacteria in the urogenital system, especially those of one group called Lactobacillus, notes a 2023 study. Probiotics can restore good bacteria and might reduce the recurrence of a UTI. Though some research suggests that probiotics may be effective in UTI prevention and treatment, more studies are needed. If you're interested in trying probiotics for urinary tract health, consider Uqora Promote Daily Probiotic supplement, a capsule designed to promote vaginal health, which in turn supports the health of the urinary tract. Read our full review of Uqora, a company that focuses on developing natural supplements for UTI prevention. Recommended products: Love Wellness Good Girl Probiotic Capsules Love Wellness Good Girl Probiotic Capsules
Get more vitamin C Increasing your intake of vitamin C may help boost your immune system. But some research has found conflicting evidence for the effectiveness of vitamin C in treating UTIs, noting that not enough studies have been done to support this treatment. Recommended products: Persona Iron with Vitamin C Persona Iron with Vitamin C
Wear loose clothing Wearing cotton-lined and loose-fitting clothing may ease symptoms of an existing UTI infection by helping to keep the area dry and clean. Tight-fitting clothing and certain types of fabric can trap moisture that allows bacteria to grow in the genital area, which could worsen the infection.
Consider switching birth control Some older research suggests that certain contraceptives may contribute to the cause of UTIs in some women. One 2023 study involving more than 24,000 cases found that there may be a small increase in the risk of UTIs with the use of contraceptives, specifically oral contraceptives, intrauterine devices, or injections. With that said, scientists have not determined the cause, and more research is needed. If you use contraceptives and get frequent UTIs, it may be worth talking with a doctor to consider other methods of birth control. You can easily obtain prescription birth control through online birth control services, where you can speak with a doctor to find the right option for you. These services vary in price and offerings, and they can be a discreet, convenient way to get the consultation and protection you need. Here are some of our favorite telehealth platforms that offer birth control prescriptions and consultations:
Use a heating pad Applying a heating pad to your lower abdomen can help ease some of the discomfort that comes with a UTI and reduce frequent trips to the bathroom that can cause painful burning. If you're experiencing severe pain that doesn't let up even with at-home methods, it's probably best to consult a doctor about your symptoms. Recommended products: Comfytemp Weighted Heating Pad for Neck and Shoulders Sunbeam Heating Pad for Neck and Shoulder Pain Relief Comfytemp Weighted Heating Pad for Neck and Shoulders Sunbeam Heating Pad for Neck and Shoulder Pain Relief
Some research has shown that UTIs may be treated without traditional antibiotics by targeting E. Coli's surface component for adhesion, FimH.
Typically, the urinary tract flushes away bacteria when you urinate. However, according to researchers, FimH can cause E. Coli to firmly attach to the cells in the urinary tract, making it hard for the body to flush the bacteria from the urinary tract naturally.
If researchers can uncover a way to target this protein with other therapies, there may someday be other treatment options for UTIs besides antibiotics.
D-mannoseD-mannose is a sugar that sticks to E. Coli. Recently, researchers have studied the possibility of using D-mannose and other mannose-containing substances to block the binding of FimH to the lining of the urinary tract.
One 2021 review concluded that D-mannose could help reduce the incidence of recurrent UTIs and improve quality of life.
A 2022 study found that patients who took D-mannose experienced symptom relief within 3 days, on par with the trial participants taking antibiotics.
Researchers in a 2023 randomized pilot study noted that D-mannose plus Saccharomyces boulardii, a probiotic, reduced the incidence of UTIs and lowered the severity of symptoms in patients with bladder cancer. We like this product from NOW Supplements, which has been vetted by our team.
More research is needed, but medications that use a mannose-containing substance could show promise for treating UTIs caused by E. Coli.
You can find D-mannose supplements online and in your pharmacy supplement aisle. Another option is FemiClear Daily Urinary Tract Flush, a daily supplement that contains D-Mannose and additional antimicrobial ingredients.
Researchers have also tested immune-boosting drugs, which could help urinary tract cells become more resistant to infections.
The American Urological Association recommends vaginal estrogen as a nonantibiotic option for perimenopausal or postmenopausal women seeking to prevent recurrent infections.
Here are a few tips for keeping UTIs at bay.
Skip bathsThe Centers for Disease Control and Prevention (CDC) recommends taking showers instead of baths to help prevent UTIs. If you're prone to frequent UTIs, you may want to swap your soothing soaks for luxurious showers.
Invest in a bidetWiping from front to back after going to the bathroom can help prevent the spread of bacteria to the urethra, but it can be tough to clean thoroughly with toilet paper alone. You can be clean without jumping in the shower by installing an inexpensive bidet attachment, like the LUXE Bidet Neo 120.
A bidet isn't just a great option for cleaning up after going number two. You can use it to freshen up after sex or while having your period.
Wash your genital area properlyProper washing doesn't include douching or the use of scented products. These can irritate and exacerbate issues down there. Instead, choose a gentle cleanser, like Cetaphil, or wash with water alone.
Drink lots of waterThe same advice for treating a UTI goes for preventing one. Drinking plenty of water regularly helps flush out nasty bacteria that can lead to infections.
What is a urinary tract infection?A urinary tract infection is a type of infection that occurs when bacteria enter the urinary tract and multiply. This infection can affect one or more areas within the urinary tract, including the:
UTIs can cause symptoms such as:
If a UTI spreads to the kidneys, which is a serious infection, you may have symptoms like:
Though UTIs can affect anyone, they're more common in women. The National Institute of Diabetes and Digestive and Kidney Diseases estimates that 40–60% of women will have at least one UTI in their lifetime.
This is because people assigned female at birth have a shorter urethra, so it's easier for bacteria to enter their bladder.
UTIs in men are often related to an enlarged prostate (benign prostatic hypertrophy) blocking the flow of urine. This allows bacteria to have an easier time occupying the urinary tract.
In almost 90% of cases, the bacterium E. Coli is the cause of the UTI. When confined to the intestines (where it's normally found), E. Coli is harmless. But sometimes, this bacterium gets into the urinary tract and causes an infection.
The severity of the infection depends on multiple factors, including:
Sex may trigger a UTI in women. This is because intercourse can move bacteria from the anal area toward the opening of the urethra. Women can lower their risk of infection by urinating after sexual activity.
Using spermicides, diaphragms, and condoms may also raise the risk of a UTI. The risk is higher in people with a weakened immune system as well.
Treatment for UTI reliefIt's standard for a doctor to prescribe antibiotics for UTI treatment.
After starting antibiotics therapy, symptoms usually improve within 2–4 days. Many doctors prescribe an antibiotic for at least 3 days.
If the UTIs don't clear up after antibiotic therapy, it may mean that you need a different type of antibiotic.
Some telehealth companies can prescribe UTI treatments remotely and deliver medications straight to your door:
The overuse or misuse of antibiotics can contribute to antibiotic resistance, a growing problem that can make it more challenging to treat issues like recurrent UTIs. Because of this risk, experts have been looking for other ways to treat UTIs alongside antibiotics.
Talk with a doctor if you have symptoms of a UTI.
Though they are painful, with antibiotic treatment and home remedies, you can address the infection and stop the pain. With proper treatment, you should begin to feel better in a few days.
Take antibiotics as instructed to prevent complications or a secondary infection even after your symptoms improve.
If the UTI doesn't resolve after antibiotic treatment or you end up with multiple episodes of a UTI, a doctor will likely do further testing.
This could be in the form of:
A doctor will be able to provide you with an evaluation tailored to your needs to make the right diagnosis and determine the proper therapy. In some cases, you may be referred to a urologist.
If you need help finding a primary care doctor, check out our FindCare tool.
What happens if a UTI isn't treated?Some serious risks can come from not treating a UTI.
The infection can sometimes spread to the kidneys and bloodstream, causing pyelonephritis. These kidney infections can lead to kidney damage and kidney scarring. If it escalates into sepsis, it can become life threatening.
Therefore, it's important to talk with a doctor and seek treatment if you suspect you may have a UTI.
Some serious risks can come from not treating a UTI.
The infection can sometimes spread to the kidneys and bloodstream, causing pyelonephritis. These kidney infections can lead to kidney damage and kidney scarring. If it escalates into sepsis, it can become life threatening.
Therefore, it's important to talk with a doctor and seek treatment if you suspect you may have a UTI.
Can UTIs go away on their own?Research estimates that 25–42% of uncomplicated UTIs in women can go away on their own.
But keep in mind that there are risks associated with not treating UTIs, so it's important to seek treatment from a healthcare professional as soon as possible.
Research estimates that 25–42% of uncomplicated UTIs in women can go away on their own.
But keep in mind that there are risks associated with not treating UTIs, so it's important to seek treatment from a healthcare professional as soon as possible.
Do you need to see a doctor to get antibiotics for a UTI?You need to speak with a doctor or a licensed healthcare professional to be prescribed antibiotics for a UTI. This can usually be done in person, at the doctor, or over the phone.
If this is your first UTI or your symptoms are severe, it may be helpful to get treated in person. You may also want to consider an in-person visit with your healthcare professional to rule out sexually transmitted infections if you're sexually active or have several sexual partners.
You need to speak with a doctor or a licensed healthcare professional to be prescribed antibiotics for a UTI. This can usually be done in person, at the doctor, or over the phone.
If this is your first UTI or your symptoms are severe, it may be helpful to get treated in person. You may also want to consider an in-person visit with your healthcare professional to rule out sexually transmitted infections if you're sexually active or have several sexual partners.
How long do UTIs last?With antibiotic treatment, symptoms of a UTI typically improve within 2–4 days.But this can vary depending on many factors, including how quickly you receive treatment, the severity of your infection, and whether any complications arise.
Keep in mind that the course of antibiotics should be completed for UTI symptoms to completely resolve and prevent recurrent infections.
With antibiotic treatment, symptoms of a UTI typically improve within 2–4 days.But this can vary depending on many factors, including how quickly you receive treatment, the severity of your infection, and whether any complications arise.
Keep in mind that the course of antibiotics should be completed for UTI symptoms to completely resolve and prevent recurrent infections.
What's the fastest way to get rid of a UTI?Antibiotics are the fastest and most effective method for treating bacterial UTIs.
Antibiotics are the fastest and most effective method for treating bacterial UTIs.
How long does it take for a UTI to go away without antibiotics?Sometimes, UTIs clear up on their own. It can take about a week for symptoms to subside.
Sometimes, UTIs clear up on their own. It can take about a week for symptoms to subside.
What's the most effective home remedy for a UTI?There's limited research on the effectiveness of UTI home remedies. If you're experiencing symptoms of a UTI, especially if they're severe, it's important to consult with a doctor.
There's limited research on the effectiveness of UTI home remedies. If you're experiencing symptoms of a UTI, especially if they're severe, it's important to consult with a doctor.
Do you need an antibiotic to get rid of chronic UTIs?A short course of antibiotics is typically the first-line treatment for UTIs. But for chronic infections, a doctor might prescribe a long-term, low dose antibiotic.
A short course of antibiotics is typically the first-line treatment for UTIs. But for chronic infections, a doctor might prescribe a long-term, low dose antibiotic.
UTIs can be very common. If you suspect you may have a UTI or are experiencing any symptoms, try these home remedies to alleviate any symptoms you're experiencing. If they don't get better or the symptoms seem worse, be sure to speak with a doctor to get a proper diagnosis and be prescribed antibiotics.
Medical School Scientist Creates Therapy To Kill Hypervirulent Bacteria
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Renee Fleeman of the University of Central Florida's College of Medicine's Burnett School of Biomedical Sciences is working on drugs to kill hypervirulent bacteria.
view moreCredit: University of Central Florida
University of Central Florida College of Medicine researcher Renee Fleeman is on a mission to kill drug-resistant bacteria, and her latest study has identified a therapy that can penetrate the slime that such infections use to protect themselves from antibiotics.
In a study published recently in Cell Reports Physical Science, Fleeman showed that an antimicrobial peptide from cows has potential for treating incurable infections from the bacterium Klebsiella pneumoniae. The bacteria, commonly found in the intestines, is usually harmless. It becomes a health hazard when it enters other parts of the body and can cause pneumonia, urinary tract and wound infections. Those at highest risk include seniors and patients with other health problems such as diabetes, cancer, kidney failure and liver disease. However, younger adults and people without additional health problems can acquire urinary tract and wound infections from the bacteria that cannot be treated by antibiotics available today.
The CDC reports that antibiotic resistant bacteria are a growing global health threat. A 2019 study found that nearly 5 million people died worldwide that year from drug-resistant infections. A large portion of those deaths are attributable to K. Pneumoniae because it has a 50% death rate without antibiotic therapy.
These bacteria are more resistant to drugs when they live in a biofilm — microorganisms that stick together and are embedded in a protective slime. Recent studies have shown that 60-80% of infections are associated with bacteria biofilms, which increase their drug resistance.
"It's Iike a coat that bacteria put around itself," Fleeman says.
Her research is examining ways to remove the protective coat and expose the bacteria so it can be killed by the body's immune system or antibiotics that currently cannot pass through the biofilm. Through that research, Fleeman discovered how the peptides made by cows can quickly kill K. Pneumoniae.
She determined that the peptides interact with sugar connections that keep the slime intact. She likened the process to cutting into a chain-linked fence. Once multiple chains are cut, the integrity of the slime structure is damaged, and the peptide can enter and destroy the bacteria that are no longer protected.
"Our research has shown polyproline peptide can penetrate and begin to break the slime barrier down in as little as an hour after treatment," says Fleeman.
The peptide has another advantage — once it breaks through the protective slime barrier, tests showed it killed the bacteria better than antibiotics used as a last resort to treat incurable infections. Peptides kill the bacteria by punching holes in their cell membrane, causing death quickly compared to other antibiotics that inhibit growth from inside the cell.
The peptide could also be used as a topical treatment for a wide range of uses, especially for the military, to treat open wounds in the field. "Bacteria divide every 30 minutes, so you have to act fast," Fleeman says.
The next phase of her research will seek to understand the biology behind the peptide's efficacy and if combinations of other drugs would aid in its application.
Her research is funded through a three-year National Institutes of Health funding Pathway to Independence R00 grant and is in its second year. Her study initially started as a K99 award at University of Texas at Austin, where she worked before joining UCF in September of 2022.
Fleeman says research into resistant infections must continue because they pose such a threat to health.
"It is estimated that by 2050, antibiotic resistant bacterial infections will be the number one cause of human deaths," she says. "Our work is focused on preparing for this post-antibiotic era battle, where common antibiotics that we take for granted will no longer be effective, jeopardizing cancer therapy, organ transplants, and any modern medical advancement that relies on effective antibiotic therapies."
JournalCell Reports Physical Science
Method of ResearchExperimental study
Subject of ResearchAnimals
Article TitlePolyproline peptide targets Klebsiella pneumoniae polysaccharides to collapse biofilms
Article Publication Date13-Mar-2024
Disclaimer: AAAS and EurekAlert! Are not responsible for the accuracy of news releases posted to EurekAlert! By contributing institutions or for the use of any information through the EurekAlert system.
Antibiotic Resistance
The problem of antibiotic resistance is an active area of research within the department. Some scientists are investigating the details and mechanisms of how bacteria acquire resistance to different groups of antibiotics. Others are looking for new ways to combat infections that resist the available antibiotic drugs. One of these groups is employing bacteriophages, while another group is working towards developing a probiotic cocktail that could be used to treat drug-resistant diseases.
Resistance to fluoroquinolone antibiotics
Dr. Lynn Zechiedrich has been studying the problem of antibiotic resistance for over 25 years. One research focus in her laboratory has been toward understanding the mechanism of action of and the mechanisms of resistance to the antibiotics known as fluoroquinolones, some of the most potent, widely prescribed, and broad-spectrum antibiotics in use world-wide. The fluoroquinolone class of antibiotics includes ciprofloxacin and levofloxacin, among others.
The fluoroquinolones act by targeting two essential bacterial enzymes known as topoisomerases - gyrase and topoisomerase IV - which help control the winding and unwinding of DNA strands during important cellular processes such as DNA replication, recombination, transcription, and chromosome segregation. During these cellular processes, DNA strands are temporarily broken by topoisomerases. The broken DNA intermediate form is normally short-lived, but in the presence of the fluoroquinolone antibiotics, the intermediate form is stabilized, resulting in bacterial cell death. The Zechiedrich laboratory uses biochemical, biophysical, and genetic approaches to determine how topoisomerases carry out their cellular roles and how drugs block their function.
In another line of research, Dr. Zechiedrich and colleagues are investigating whether the drug ciclopirox, an off-patent anti-fungal agent, could be repurposed as a candidate for antibiotic use, particularly against multidrug resistant gram-negative bacteria. The ability to use a drug designed to combat one type of microorganism for use against another could circumvent the time and money associated with developing a new drug.
The Zechiedrich group reported that ciclopirox inhibited the growth of even multidrug-resistant gram-negative bacteria Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae. They further investigated the mechanism of action and found that the drug affected sugar metabolism in the bacteria, altering the composition of molecules in the outer membrane of the bacterial cell. In their current research in this area, they are pursuing the drug target as a potentially new target for new antibiotic development.
Resistance to beta-lactam antibiotics
Beta-lactam antibiotics are the most widely used class of drugs for the treatment of bacterial infections. They include penicillin and its derivatives, such as methicillin and amoxicillin, as well as other groups of antibiotics known as the cephalosporins, carbapenems, and monobactams. The beta-lactam ring portion of the antibiotic targets the penicillin-binding proteins (PBP), found in the bacterial cell membrane, which function in the synthesis of the cell wall. Binding of the antibiotic to the PBPs prevents the PBPs from performing their essential role and results in the death of the bacterial cell.
Dr. Timothy Palzkill, professor of Pharmacology and Chemical Biology and Molecular Virology and Microbiology, and his research team have been studying mechanisms of resistance to the beta-lactam antibiotics. In gram-negative bacteria, the most common mechanism of resistance is the hydrolysis, or breaking apart, of the antibiotics by enzymes referred to as the beta-lactamases. There are two broad classes of beta-lactamases, the serine-β-lactamases and the metallo-β-lactamases. Dr. Palzkill and his group use a variety of advanced genetic, biochemical, and physical techniques to understand details about the structure and function of both groups of the beta-lactamases and their interactions with drug-resistant forms of antibiotics that are subject to drug resistance.
Instead of drug resistance through the action of beta-lactamases, gram-positive bacteria acquire resistance to beta-lactam antibiotics through the production of a protein called PBP2a, which is able to avoid the inhibitory effects of the antibiotics. This is the mechanism by which methicillin-resistant Staphylococcus aureus (MRSA) is able to persist despite treatment with multiple beta-lactam antibiotics. Dr. Palzkill and coworkers conducted a study in which they found that the protein BLIP-II was able to weakly bind and inhibit PBP2a, making it susceptible to beta-lactam antibiotics. They are continuing this line of research by searching for mutations that increase the affinity of BLIP-II to PBP2a.
Resistance to colistin
The reduction in treatment options due to the increased prevalence beta-lactamases that break down beta-lactam antibiotics has led to the increased use of polymyxin antibiotics such as colistin. Polymyxins are polypeptides that act by binding to and subsequently disrupting the bacterial membrane. The recent emergence and spread of a plasmid-encoded, transferable colistin resistance gene, mcr-1, is a cause for concern. The mcr-1 gene encodes an enzyme, MCR-1, that modifies a component of the membrane and blocks colistin binding.
Dr. Palzkill and his group have determined the X-ray structure of one important functional region of the MCR-1 protein. In order to more fully understand the mechanism of MCR-1, they are working to determine the structure of the full-length MCR-1 enzyme. In addition, the laboratory is working to discover inhibitors of the MCR-1 enzyme that would circumvent resistance and broaden treatment options for colistin.
Use of bacteriophages to combat antibiotic-resistant bacteria
Bacteriophages are viruses that specifically kill bacteria. Drs. Anthony Maresso, Frank Ramig, and Barbara Trautner and their colleagues have been investigating the feasibility of using bacteriophages, or phages, to combat drug-resistant bacteria. This idea was originally proposed by Felix d'Herelle in 1926, but following the discovery and initial successes of antibiotics, this approach was largely dropped (although several Eastern European nations have used this approach to successfully treat some bacterial infections).
Given the current limitations in treating drug-resistant bacterial infections, the researchers have revisited this idea and set about to determine whether phages can be effective at killing a large group of bacteria that are resistant to antibiotics. Their bacterial target was a specific group of Escherichia coli, called ST131, that colonize the gastrointestinal tract, but can infect sites outside the intestines (this category of E. Coli is known as extraintestinal pathogenic E. Coli), and is considered the predominant cause of all antibiotic-resistant E. Coli infections in the United States. The bacteria are multi-drug resistant, in addition to producing deadly virulence factors; failure to control their growth can lead to sepsis, which can be fatal.
In their study, they sought to identify phages that would kill 12 strains of antibiotic-resistant bacteria that were isolated from patients. They did this by first isolating phages from the feces of birds and dogs, which are known to be reservoirs for the E. Coli ST131 bacteria, and then testing to see if the phages lysed, or killed, the bacteria in a laboratory test. Although no single phage could kill all 12 bacterial strains in lab cultures, they found combinations of two or three phages that were effective against all the bacteria they tested.
Next, they tested the phages to find out if they could also kill the antibiotic-resistant bacteria in a mouse model of sepsis. When delivered into the animals, the phages reduced the levels of bacteria and substantially improved the health of the mice. The results demonstrated that phages isolated from the environment, with little experimental manipulation, can be effective in combating even very serious infections by E. Coli superbugs.
There are several advantages to using phages instead of antibiotics to combat bacterial infections. Phages do not infect human cells. They are very specific for certain species or strains of bacteria, so that they can be used to target the "bad" bacteria, while not harming the "good" intestinal microbiota. However, they can be made to act broadly via cocktails, if desired. In addition, phages can evolve, so should resistance against a set of phages develop, new phages could be identified in the environment or evolved in the laboratory in a matter of days, unlike antibiotics which can take many years, at great cost, to develop. While the scientists are still somewhat cautious about this approach, as sometimes a host's immune system can neutralize the activities of phages and some phages may not work well in animals, they are continuing to explore this option.
In another study, these researchers found that certain metals enhance the killing of E. Coli ST131 bacteria by phages in blood. They observed that when they treated E. Coli ST131 with phage, the phage effectively killed the bacteria in culture medium but not in blood. The blood samples contained a chemical called EDTA which was used to prevent clotting and is known to bind to metals. They saw more efficient bacterial killing in blood treated with heparin, a natural anti-clotting factor, suggesting that the differing outcomes may be due to the level of metals in the blood.
When they added the metals calcium, magnesium, and iron, which are commonly found in blood, they found that the inhibition of ST131 killing by EDTA was overcome by the addition of the metals. Furthermore, metal-enhanced killing was observed for several other strains of extraintestinal pathogenic E. Coli, not only ST131. Metals also enhanced ST131 killing in a mouse model system. This work points to the essential role of metals for bacterial killing by phage in blood.
Antibiotic treatment alters the intestinal microbiota resulting in hard-to-treat Clostridium difficile infections
Clostridium difficile is a gram-positive, spore-forming bacterium that is considered to be one of the three highest risk drug-resistant infections in the United States, as classified by the CDC. It is an opportunistic infection that infects the colon of patients following antibiotic treatment. The microbiota that inhabit the gut normally prevent C. Difficile colonization and suppress C. Difficile-associated disease, but treatment with antibiotics results in changes to the composition of microbiota that allow C. Difficile to grow and cause disease.
C. Difficile produces toxins that damage intestinal cells and cause inflammation, producing diarrhea, and can be fatal. Of nearly 500,000 infections each year, approximately 29,000 result in death. It is the most common cause of hospital-acquired infections in developed countries. The infection is very difficult to treat, with many patients suffering from recurrent infections. The bacterium is naturally resistant to many common antibiotics, such as the fluoroquinolones, so investigators are searching for alternate ways to treat the disease.
Dr. Robert Britton and his research group are interested in understanding how the intestinal microbiota provides a barrier to incoming pathogens and how perturbation of the microbiota can result in infections, primarily C. Difficile infections. They have developed mini-bioreactors and mice colonized with a human intestinal microbiota to determine which members of the microbial community are responsible for inhibiting C. Difficile invasion. Their goal is to develop a probiotic cocktail, derived from the human intestinal microbiota, that will suppress C. Difficile invasion.
Researchers have found that two C. Difficile lineages, RT027 and RT078, have become more predominant and virulent in the last couple of decades, causing major outbreaks. To identify factors that have enhanced the virulence of these two lineages, Dr. Britton and his colleagues investigated what sources of food RT027 and RT078 preferred. Their study showed that the virulent lineages were highly efficient in their use of the dietary sugar trehalose (which is found in diet soda and is used to stabilize processed foods), giving these microbes a competitive advantage over other, less virulent bacteria.
Using their mouse model, they found that the mice receiving trehalose in their diet had more severe disease, with higher mortality rates, and they produced higher levels of toxins. These results suggest that the introduction of trehalose as a food additive into the human diet, shortly before the emergence of these two epidemic lineages, helped select for their emergence and contributed to virulence. This study further demonstrates that diet can influence the composition of the microbiota and response to infection.
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