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Thread: Pilot trial of bacterial interference for preventing urinary tract infection

  1. #1

    Pilot trial of bacterial interference for preventing urinary tract infection

    • Darouiche RO, Donovan WH, Del Terzo M, Thornby JI, Rudy DC and Hull RA (2001). Pilot trial of bacterial interference for preventing urinary tract infection. Urology. 58 (3): 339-44. Summary: Objectives. To examine the safety and efficacy of bacterial interference in preventing symptomatic urinary tract infection (UTI).Methods. A prospective, nonrandomized, pilot clinical trial was conducted in patients with spinal cord injury who had neurogenic bladder and had frequent episodes of symptomatic UTI. The bladder of patients was inoculated with a nonpathogenic prototype of Escherichia coli 83972. The rate of symptomatic UTI in successfully colonized patients while colonized with E. coli 83972 was compared with (a) their own baseline prestudy rate and (b) the rate of symptomatic UTI in patients who were not successfully colonized.Results. Of 44 inoculated patients, 30 (68%) became colonized with E. coli 83972 for 1 month or longer. Only two episodes of symptomatic UTI occurred in the group of 30 patients while colonized with E. coli 83972 (a total of 34 patient- years), and none was attributed to E. coli 83972. The group of 30 patients experienced a 63-fold reduction in the rate of symptomatic UTI while colonized with E. coli 83972 versus their baseline prestudy period (mean 0.06 versus 3.77 episodes of symptomatic UTI/patient-year, P <0.001). The rate of symptomatic UTI was also 33-fold lower in this group of 30 patients while colonized with E. coli 83972 than in the well-matched group of 14 patients who were not successfully colonized [mean 0.06 versus 1.80 episodes of symptomatic UTI/patient-year, P <0.001).Conclusions. The results of this pilot study indicate that bacterial interference using E. coli 83972 may be safe and effective in preventing UTI. <http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11549475> Veterans Affairs Medical Center, Houston, Texas, USA

  2. #2

    re - bacterial interference and UTI

    I must say I shuddered when I read about introducing E. coli into a body!

    My son was recently put on a Renacidin (sp) irrigation twice a day for the main purpose of trying to prevent bladder 'grit' and stones which he had at an alarming rate (i.e. cystos once a month, and sometimes cath changes 2-3 times a week!); the Renacidin is working beautifully in preventing stone formation, but an added side effect we have all noticed is that he has had NO UTI's since we started the irrigations! We're doing the irrigations twice a day at 30 cc. per dose, and he's getting his magnesium levels, etc., monitored periodically.

  3. #3
    I was really struck by the incredible success rate of this study. Even though the number of patients is small (30 patients) and the investigators called with a "pilot study", it would seem to me that a 63-fold reduction in the rate of symptomatic infection is stunning.

    Marmalady, stones themselves harbor bacteria and provide a nidus of infection. However, the same principles may succeed in colonizing the stones and "grit" with non-pathogenic bacteria.

    Wise.

  4. #4

    Pilot study - UTI's

    Wise - Do you know if there are plans to do a study with a larger subject base? Such an interesting study and outcome. CRF

  5. #5
    Sorry, I have heard of a study. If you do, can you post? Wise.

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