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Biofilms In Recurrent Urinary Tract Infections

- 8 min read
written by Shield Connect

Urinary tract infections (UTIs) are relatively common and affects persons of all ages. Frequency of UTIs is higher in women than in men.

Urinary tract infections (UTIs) are relatively common and affects persons of all ages. Frequency of UTIs is higher in women than in men. the assigning factors could be the shorter urethra, or the lower region of the urethra contaminated with pathogens starting from the vagina and the rectum. Like men, Women do not to empty their bladders frequently and completely. It is estimated that 40%of women will have an UTI at some time in their lives.

Bacterial biofilms play crucial role in UTIs an disaccountable for persistence infections triggering relapses.

“Biofilm is a mode of microbial growth where dynamic communities of interacting sessile cells are irreversibly attached to a solid substratum, as well as each other, and are embedded in a self-made matrix of extracellular polymeric substance (EPS)”-Ingle

Characteristics Of Biofilm

Bacteria in the biofilm provides a unique capacity to survive tough growth and environmental conditions.

  1. Biofilm structure protects the residing bacteria from environmental threats.
  2. Structure of biofilm permits trapping of nutrients and metabolic cooperativity between resident cells of the same species and or different species.
  3. Biofilm structure displays organized internal compartmentalization.
  4. Bacterial cells in a biofilm community may communicate and exchange genetic material to acquire new traits.

Development Of Biofilm

Bacteria can form biofilm on any surface that is bathed in a nutrition containing fluid. There are 3 major components involved in biofilm formation. They are
1. Bacterial cells
2. A solid surface
3. A fluid medium

These components are Influenced by the physicochemical properties of the components involved in the biofilm.

Resistance of Microbes in the Biofilm to Antimicrobials

The nature of biofilm structure and physiological characteristics of resident microorganisms offer an inherent resistance to antimicrobial agents, such as antibiotics, disinfectants, or germicides.
Mechanism responsible for resistance:

1. Resistance associated with extracellular polymeric matrix [EPS].
2. Resistance associated with growth rate and nutrient availability.
3. Resistance associated with adoption of resistance phenotype.

Available Treatment options

Treating Biofilm is difficult due to the high level of antimicrobial resistance. Many new therapeutic options are being studied. Rifampicin-Minocycline-coated catheters have been shown to inhibit the biofilm formation of Gram-positive and Gram-negative pathogens. Nanoparticles have the capacity to attach and penetrate bacterial cells, disrupt the bacterial membrane, and interact with chromosomal DNA. The use of liposomes could be another method for improving the effectiveness of antibiotics. Quorum sensing (QS) used to coordinate gene expression and regulate numerous processes that are involved in virulence. Antiadhesive compounds is of current interest in clinical research.

To conclude Sessile biofilm bacteria are phenotypically different than planktonic bacteria, granting increased resistance to antibiotics, and the immune response. Antibiotics can kill the planktonic cells released by the biofilm after its maturation stages, but bacteria within the biofilm can persist, causing chronic infections inhibition of biofilm formation by pathogenic bacteria has become an attractive therapeutic target. Although standard treatment for UTI starts with antimicrobial therapy, there are different treatment strategies open to reduce exposure to antibiotics, such as the use of probiotics, cranberry juice, etc. Probiotic strains that have both anti-biofilm and antimicrobial activities can be of clinical importance. Cranberry juice is very well studies to prevent infections of the urinary tract, which are related to biofilm formation. Many studies have reported that A-type Proanthocyanidins from cranberries have a potential anti-biofilm property against infectious Bacteria.

References:

1. Flemming HC, Wingender J. The biofilm matrix. Nat Rev Microbiol. 2010;8(9):623–633.
2. Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms: a common cause of persistent infections. Science. 1999;284(5418):1318–1322.
3. Foo LY, Lu Y, Howell AB, Vorsa N. A-Type proanthocyanidin trimers from cranberry that inhibit adherence of uropathogenic P-fimbriated Escherichia coli. J Nat Prod. 2000;63(9):1225–1228.
4. Ghane M, Babaeekhou L, Ketabi SS. Antibiofilm Activity of Kefir Probiotic Lactobacilli Against Uropathogenic Escherichia coli (UPEC). Avicenna J Med Biotechnol. 2020;12(4):221-229.

Picture Credit: Biofilms & Urinary Tract Infections…A Sticky Situation- Clinician’s Brief.

Dr Sadhana Gupta Dr Sadhana Gupta

Director & Senior Consultant OB Gyn, Jeevan Jyoti Hospital & Medical Research Centre, Gorakhpur, Uttar Pradesh, India.

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