H2O2-PRODUCING LACTOBACILLI AND POSTMENOPAUSAL UTI

说明(改编自应用程序) 尿路感染每年影响700多万女性， 尿路感染的发生率随着年龄的增长而增加。尽管有明显的进步 在我们对年轻成年女性尿路感染发病机制的理解中， 绝经后妇女尿路感染的发病机制和流行病学研究 了解很少，特别是在非机构化的部分 人口。经阴道定植的大肠杆菌已被证明是一种重要的 尿路感染发生在尿路感染之前，在绝经后妇女中非常普遍。在……里面 体外研究表明，正常阴道的主要成分 产H202的乳酸菌对大肠杆菌有抑制作用。我们最近的数据 证明，在存在之间确实存在相反的关系 产H202乳酸菌和大肠杆菌阴道定植的研究 有反复尿路感染的绝经前妇女。然而，风湿病的流行 产H_(202)乳杆菌及其与阴道菌的关系 绝经后妇女的移居率和尿路感染的发病率 被刻画出来了。一项前瞻性评估的发病率和风险 1000名社区居住绝经后妇女尿路感染的影响因素(DK43134， 史蒂芬·D·芬，医学博士，公共卫生硕士)已在 普吉特湾，华盛顿州西部的一家以人口为基础的医疗保健组织。基于我们的 在绝经前妇女中的发现，我们正在提议进行更多的研究，将 使我们能够(1)确定阴道乳杆菌的流行率， 以H202状态和物种为特征的绝经后妇女；(2) 产H202乳酸菌与大肠杆菌关系的检测 阴道定植；(3)将这一信息与尿路感染和 考虑暴露因素时绝经后妇女的无症状菌尿 例如雌激素的使用、糖尿病和抗菌药物的使用；(4)评估 引起膀胱炎的大肠埃希氏菌尿毒力基因的流行 以及(5)评估使用乳酸菌的可行性 用于预防绝经后妇女尿路感染的益生菌。这些额外的研究将 需要流行病学、生物统计学和实验室方法的结合 它与结构化的教学和课堂教学相结合，将 为应聘者的发展提供良好的培训经验 成为一名成功的、独立的临床研究人员。

DESCRIPTION (adapted from the application) Urinary tract infections affect over 7 million women per year, and the incidence of UTI increases with advancing age. Although marked strides have been made in our understanding of the pathogenesis of UTI in young adult women, the pathogenesis and epidemiology of UTI among postmenopausal women remain poorly understood, especially among the non-institutionalized segment of the population. Vaginal colonization with E. coli has been shown to be an important event preceding UTI, and it is highly prevalent in postmenopausal women. In vitro studies suggest that the predominant constituents of normal vaginal flora, H202-producing lactobacilli, are inhibitory to E. coli. Our recent data demonstrate that there is, indeed, an inverse relationship between the presence of H202-producing lactobacilli and E. coli vaginal colonization in premenopausal women with recurrent UTI. However, the prevalence of H202-producing lactobacilli, and their relationship to vaginal E. coli colonization and to the incidence of UTI among postmenopausal women has not been characterized. A prospective evaluation of the incidence of and risk factors for UTI in 1000 community-dwelling postmenopausal women (DK43134, Stephan D. Fin, MD, MPH) has been initiated at the Group Health Cooperative of Puget Sound, a population-based HMO in western Washington. Based on our findings in premenopausal women, we are proposing additional studies which will enable us to (1) establish the prevalence of vaginal lactobacilli, characterized by H202 status and by species, in postmenopausal women; (2) examine the relationship between H202-producing lactobacilli and E. coli vaginal colonization; (3) relate this information to the incidence of UTI and asymptomatic bacteriuria in postmenopausal women while accounting for exposures such as estrogen use, diabetes, and antimicrobial use; (4) assess the prevalence of urovirulence genes in E. coli strains causing cystitis in postmenopausal women; and (5) assess the feasibility of using a lactobacillus probiotic to prevent UTI in postmenopausal women. These additional studies will entail a combination of epidemiological, biostatistical, and laboratory methods which, in combination with structured didactic and classroom instruction, will provide an excellent training experience for the development of the Candidate into a successful, independent, clinical investigator.