Results 1 to 5 of 5

Thread: Prevention of UTI using E. Coli in SCI Patients

  1. #1
    Senior Member martha's Avatar
    Join Date
    Jul 2001
    Location
    Texas hallelujah!
    Posts
    1,077

    Prevention of UTI using E. Coli in SCI Patients

    My husband has problems with recurrent UTI's every 6-8 weeks. He is on IC, sterile kits, every 4 hours or more frequently. He is starting a protocol at TIRR (ugh) where they place E.Coli into the bladder "to establish and maintain for extended periods of time asymptomatic colonization of the human bladder and to suppress symptomatic infection of both the normal and neurogenic bladder."

    Has anyone else been involved in this study and if so, what were your results?

    Also, he has LOTS of bladder accidents -- several days a week and at least 5 nights a week. He caths large volumes (anywhere from 400 to 900) but when we saw the urologist, he would only admit to having occasional accidents "when he felt he was getting an infection". We got into a bit of an argument in front of the urologist, and needless to say he was fairly upset with me.

    I don't think this study will have anything to do with the large volumes and number of accidents. I think the accidents and the infections are two separate issues. Or am I wrong? He had a urodynamics study done last October and everything was normal with that.

    Opinions please!
    thanks,
    martha

  2. #2
    Of course it is always important to be honest and upfront with your care providers. People often do this to "save face" or because they are not following their physician's advice and are ashamed or embarrassed to admit it. Hiding what is actually happening with his bladder essentially ties his physician's hands in helping him with his repeated UTIs.

    Participating in a study under false pretenses also could lead to poor validity and reliability of the study.

    Both high pressures and high cath volumes are implicated in repeated UTIs, as well as increased accidents. Cath volumes over 450 cc. are generally discouraged for this reason. There are really no good studies that support sterile vs. clean catheterization as long as other variables are equal (cath volumes, control of bladder pressure, good hand washing, etc.)

    I would suspect that your husband is in a double blinded study where he could actually be in the placebo group as well as the experimental group, correct? Most studies such as this neither the patient or physician knows which patient got which treatment until after the study is completed. If this is the case, others in the same study would also not know about any results.

    This study was based on a similar study done with AB women who were subjected to frequent UTIs. In this group, UTIs from E.Coli are very common. In people with SCI, while E.Coli infections are seen, they also often have infections from other bacteria that are unlikely to be effected by this experimental protocol.

    I would encourage your husband to call his urologist back and "fess up" to not telling him what was really going on with his bladder. Not doing so can only lead to him not getting the appropriate medical advice that he needs.

    (KLD)

  3. #3
    Senior Member martha's Avatar
    Join Date
    Jul 2001
    Location
    Texas hallelujah!
    Posts
    1,077
    KLD, thanks. I'll call tomorrow and talk to them since I know he won't. Actually it isn't a double blind study -- everyone gets the bacteria according to the reams of info we were given. Apparently it doesn't "take" in everyone and we were told ways to be able to tell if it was colonizing in him. It should be interesting. We'd do about anything to stop these recurrent UTI's.

    I'm confused (again). You said in people with SCI, while E.Coli infections are seen, they also often have infections from other bacteria that are unlikely to be effected by this experimental protocol. What we were told, and what the information sheet explains, was that the E.Coli is a benign bacteria injected to colonize the bladder and that this benign bacteria is dominant and will act as a defense to prevent other harmful bacteria from colonizing and causing infection.

    martha <------ going through life confused.

  4. #4
    Senior Member Jeff's Avatar
    Join Date
    Jul 2001
    Location
    Argao, Cebu, Philippines
    Posts
    6,864
    Oh man. If colonizing the bladder with benign E. Coli is only good at preventing infections from specifically other E. Coli, then I will be really upset. I've been counting on this development for a long time.

    The one silver lining is that preventing E. Coli infections will, for me, prevent multi-drug resistant infections.

    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

  5. #5
    Senior Member martha's Avatar
    Join Date
    Jul 2001
    Location
    Texas hallelujah!
    Posts
    1,077
    Originally posted by Jeff:

    Oh man. If colonizing the bladder with benign E. Coli is only good at preventing infections from specifically other E. Coli, then I will be really upset. I've been counting on this development for a long time.
    Jeff, that wasn't what we were told or what the literature we were given states. It says that "E.Coli 83972 has been able to keep persons with SCI free from symptoms of UTI for as long as they remain colonized with this organism". 30 male patients colonized for 40 patient years experienced 0.09 UTI per year as opposed to 4 UTI in the year prior to the colonization. I think we could live with 0.09 UTI's per year as opposed to the 6-8 per year he's having now.

    I guess time will tell.

    [This message was edited by SCI-Nurse on 07-14-03 at 01:08 AM.]

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •