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Bacterial Persistence in Urinary Tract Infection Among Postmenopausal Population.

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Bacterial persistence in urinary tract infections (UTIs) was observed in older women, even with antibiotic treatment. Fosfomycin showed the most promise in reducing these persistent bacteria.

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Area of Science:

  • Urology
  • Infectious Diseases
  • Microbiology

Background:

  • Urinary tract infections (UTIs) are highly prevalent in postmenopausal women.
  • Bacterial persistence is a growing concern in treating recurrent UTIs.
  • Understanding antibiotic efficacy against persister cells is crucial for effective treatment.

Purpose of the Study:

  • To quantify the bacterial persister phenotype in urine samples from postmenopausal women with UTIs.
  • To evaluate the effectiveness of first-line antibiotics against bacterial persister cells.
  • To investigate bacterial persistence as a potential mechanism in UTIs.

Main Methods:

  • Cross-sectional analysis of uropathogens from postmenopausal women with acute or recurrent UTIs.
  • Persistence assays were used to screen for bacterial persister cells.
  • Statistical analysis (ANOVA) compared antibiotic treatment effects on colony-forming units.

Main Results:

  • The persister phenotype was present in all *Escherichia coli* isolates.
  • Fosfomycin treatment significantly reduced bacterial colony-forming units compared to controls.
  • All four tested antibiotics showed a statistically significant decrease in colony-forming units for recurrent UTIs.

Conclusions:

  • Bacterial persistence occurs in vitro in uropathogens from urogynecology patients despite antibiotic exposure.
  • Fosfomycin demonstrated the greatest reduction in persister cell formation.
  • Bacterial persistence may represent a defense mechanism contributing to UTI development and recurrence.