MECHANISM OF RECURRENT URINARY TRACT INFECTIONS IN WOMEN

女性复发性尿路感染的机制

• 批准号: 3790884
• 负责人: T A RUSSO
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3790884
• 关键词: Escherichia coli infections; female; genetic strain; genotype; human subject; molecular pathology; pulsed field gel electrophoresis; relapse /recurrence; urinary tract infection

The most common site for extra-intestinal Escherichia coli infection is the urinary tract. There are a number of risk groups for this site of infection, one of which being young women in their sexually active years. Infection in this group accounts for 6-7 million office visits annually in the United States. Escherichia coli isolates are responsible for greater than 80-90% of these episodes. About 250,000 of these infections progress to acute pyelonephritis. In approximately 20% of these women frequent recurrences of infection (3-6/annum) follow the first episode. The morbidity, time lost from work of cost of infectious syndrome is considerable. An improved understanding of the pathogenesis of this disease would be of significant importance. It is believed that the vast majority of recurrent UTIs are episodes of reinfection with different strains of E. coli rather than persistance of a single strain. We are employing pulse field gel electrophoresis to generates DNA "fingerprints" of bacterial strains isolated from women with recurrent UTIs. This will allow use to definitively establish how frequently a single strain versus different strains are responsible for this pattern of infection. Our studies to date on isolates from eight women suggests that infection from a single strain my occur more frequently than is presently suspected. If a single strain is responsible for the majority of recurrent UTIs our therapeutic approach in this subset of women will be altered. Several possibilities could account for the above findings. We plan to genotype serially collect isolates from a larger number of women with recurrent UTIs. This will confirm the above findings, we also plan to genotype fecal isolates from these women that were collected in between and during infectious episodes. This data should clarify whether the responsible strain was persisting within the gastro-intestinal tract or within the urinary tract.

肠外大肠杆菌感染最常见的部位是 尿路。有一些风险群体为这个网站的 感染，其中之一是性活跃的年轻妇女， 年这一群体中的感染占600万至700万次办公室就诊 每年在美国。大肠杆菌分离株负责 超过80-90%的此类事件。其中大约25万个 感染进展为急性肾盂肾炎。约20%的 这些妇女经常复发感染（3-6/年）， 第一集传染病的发病率、误工费、 综合症是相当可观的。对发病机制的进一步了解 这种疾病的治疗意义重大据信 绝大多数复发性UTI是再感染的发作， 不同菌株E.而不是单一菌株的持久性。 我们采用脉冲场凝胶电泳技术 从复发性乳腺癌妇女中分离出的细菌菌株的“指纹” 尿路感染这将允许使用明确地确定 单一菌株与不同菌株的对比导致了这种模式 感染 我们迄今为止对八名妇女的分离株的研究表明， 从一个单一的菌株可能会发生更频繁地比目前 疑似如果一个单一的菌株是负责大多数 复发性尿路感染，我们对这部分女性的治疗方法将是 改变了有几种可能性可以解释上述调查结果。我们 计划从大量妇女中连续收集分离株进行基因分型 复发性尿路感染这将证实上述发现，我们还计划 对这些妇女的粪便分离物进行基因分型， 在传染病发作之间和期间。这些数据应该说明， 致病菌株在胃肠道内持续存在 或在泌尿道内。