Bacterial Persistence in Urinary Tract Infection Among Postmenopausal Population

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.