Urinary tract infections are a special kind of hell. The stinging. The burning. The constant urge to pee and then not being able to pee when you finally get so uncomfortable that you have to go sit on the toilet again. But the only thing worse than a UTI would be an untreatable UTI, which is a terrifying future we might actually see if we don't start looking for alternatives to antibiotics for treating these common infections.
Luckily a new study published in Nature Monday taking a closer look at E. coli—the bug that causes about 80 percent of all UTIs—offers a potential new treatment method that wouldn't require using antibiotics. That's great news because antibiotics are overused in general, contributing to the growth of antibiotic resistant superbugs. Even UTIs are starting to fall victim, with treatments become less effective, particularly for people who are prone to the infections and are prescribed the same antibiotics over and over.
"Whether you're thinking about antibiotics on orchard trees or on livestock or on people, unless you use them only when it's absolutely necessary, they're just contributing to the overall problem of antibiotic resistance," said Dr. David Wallinga, a Senior Health Officer for the Natural Resources Defense Council. "Even if you're using it for valid reasons, like UTIs, it's still exposing bacteria to the drugs and spurring them to take on resistance. So that's why it's important to only use them when you really have to."
In the paper, a group of researchers from Switzerland detail how E. coli is able to latch onto cells in the body and actually hold on more tightly when encountering tensile forces. In other words, when you pee, urine is supposed to flush out any bacteria in the urethra. The trouble with UTIs is that as you pee the force of the urine only causes the E. coli to grip more tightly and ride it out.
Anyone who's ever suffered through a urinary tract infection probably won't be surprised to learn the bacteria that causes the burning, stinging discomfort has the ability to cling onto the inside of your body for dear life, but the study authors were able to pinpoint exactly how it work. Chains of FimH, a type of protein, attaching to human cells are the culprit behind E. coli's vice grip. The researchers showed that, if you could knock out these proteins through targeted medicine, you could make it possible for the body to naturally flush out the bacteria without requiring antibiotics to attack and kill the E. coli. In fact, the same team is currently testing out an oral treatment that would specifically target FimH to treat UTIs.
Antibiotics are really effective for treating UTIs, but they're also overused throughout medicine and in agriculture. This abuse of antibiotics contributes to the development of antibiotic-resistant bacteria, and E. coli is no exception. For years now, researchers have been documenting the reduced effectiveness of the antibiotics used to treat UTIs and the increased antibiotic resistance in E. coli. Even though antibiotics sometimes make sense for treating UTIs—unlike using antibiotics to treat viral infections, which is ineffective—if there are other potential options, we should definitely be pursuing them. For women with recurrent UTIs, which can become resistant to all the commonly-used antibiotics an effective, alternative treatment would be a Godsend.
"We'll always need antibiotics, but when you're dealing with a multidrug-resistant infection, there's a growing concern that our arsenal of new drugs is running dry," said Carolyn Shore, a microbiologist who works on the Antibiotics Resistance Project for Pew Charitable Trusts. "There really are not a lot of new drugs coming through our antibiotic development pipeline, and so alternative approaches are getting more attention."
Targeting FimH might not be the only option out there, either. Last year, researchers in the US published a study that showed an immune-boosting agent could help the body naturally resist E. coli from taking hold in the urinary tract. Future treatments may even combine these different strategies to give us a powerful solution for fighting UTIs without adding to the overuse of antibiotics. Considering how common UTIs are—up to 8 million Americans are diagnosed with a UTI each year—if we could eliminate antibiotics for most treatment, it would make huge impact in reducing our overall antibiotic use.