Prospective Study in Children with Complicated Urinary Tract Infection Treated with Autologous Bacterial Lysates
Ulises Hernández-Chiñas1, María E Chávez-Berrocal1, Ricardo E Ahumada-Cota1
1Peripheral Unit of Basic and Clinical Research in Infectious Diseases, Public Health Department, Research Division, Faculty of Medicine Universidad Nacional Autónoma de México, Bacterial Pathogenicity Laboratory, Hemato-Oncology and Research Unit, Children's Hospital of Mexico Federico Gómez, Dr. Márquez 162, Col. De los Doctores, Mexico City 06720, Mexico.
Insights
Autologous bacterial lysates (ABL) offer a promising alternative therapy for children with recurrent urinary tract infections (rUTI). ABL treatment demonstrated significant control of infection for up to one year in over 60% of pediatric patients.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Immunology
Background:
- Antimicrobial resistance is a significant challenge in managing recurrent urinary tract infections (rUTI) in children.
- Alternative therapeutic strategies are urgently needed to combat resistant bacterial strains.
Purpose of the Study:
- To evaluate the efficacy of autologous bacterial lysates (ABL) as a potential treatment for pediatric rUTI.
- To investigate the impact of ABL on bacterial load and infection recurrence in children.
Main Methods:
- Twenty-seven children with rUTI were enrolled; urine and stool cultures were analyzed.
- Escherichia coli isolates were serotyped, and ABL was manufactured for patients with significant bacteriuria (≥10^5 UFC/mL).
- ABL was administered orally (1 mL/day) for one month, with follow-up monitoring for up to one year.
Main Results:
- Escherichia coli was the predominant pathogen (80.5% in urine, 72% in feces).
- Specific Uropathogenic E. coli (UPEC) serotypes (O25:H4, O75:HNM, O9:HNM) were identified in persistent infections.
- After 3 months of ABL treatment, 54% of patients showed bacterial absence in urine, with 42% remaining UTI-free at 10-12 months.
Conclusions:
- Autologous bacterial lysates (ABL) effectively controlled infection for nearly one year in over 60% of treated children.
- The development of a polyvalent immunogen is recommended for improved treatment and control of pediatric rUTI.
Abstract:
Antimicrobial bacteria resistance is an important problem in children with recurrent urinary tract infections (rUTI), thus it is crucial to search for alternative therapies. Autologous bacterial lysates (ABL) may be a potential treatment for rUTI. Twenty-seven children with rUTI were evaluated for one year, urine and stool cultures were performed, 10 colonies of each culture were selected and those identified as Escherichia coli were characterized by serology. For patients who presented ≥105 UFC/mL, an ABL was manufactured and administered orally (1 mL/day) for a month. Twelve children were monitored for ≥1-year, 218 urine and 11 stool samples were analyzed. E. coli (80.5%) was the main bacteria isolated from urine and feces (72%). E. coli of classical urinary serotypes (UPEC), O25:H4, O75:HNM, and O9:HNM were identified in patients with persistent urinary infection (pUTI). In 54% of patients treated with ABL, the absence of bacteria was observed in urine samples after 3 months of treatment, 42% of these remained without UTI between 10-12 months. It was observed that the use of ABL controlled the infection for almost 1 year in more than 60% of the children. We consider it necessary to develop a polyvalent immunogen for the treatment and control of rUTI.
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