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Saturday 31 May 2014

Chitosan, a chemical, can help fight persistent urinary tract infections by exposing dormant pathogens to antibiotics

TRADITIONALLY, urinary tract infections (UTI) have been treated with antibiotics. But despite the treatment, sometimes bacteria can hide in the bladder and form a dormant reservoir of pathogens. These reservoirs can later release a burst of infecting pathogens and cause recurring infections.

A group of scientists from the US and SloveniaÔÇê claim to have found a way to get rid of these hard-to-reach bacteria. Working with mice, the team found that in the presence of a chemical called chitosan these hiding bacteria can be forced to come out in the open, inside the bladder. This makes them amenable to an antibiotic treatment.

The team started with testing the effects of chitosan on the growth and survival of a common UTI-causing bacteria. They found that chitosan affected the way bacteria attached itself to the inner walls of urinary tract. Armed with this piece of information, they decided to test the effects of chitosan in the bladder of mice. For this, mice were anaesthetised and chitosan was introduced in the bladder via a catheter.

The study was led by Matthew Blango from the Division of Microbiology and Immunology, University of Utah, US. He says, “Chitosan causes a release of the bacteria from the cells lining the bladder wall because it provokes the host cell to divide. We found that coupling a chitosan treatment with an antibiotic treatment of sparfloxacin or ciprofloxacin for seven days helped clear the majority of the bacteria from the bladder. The team is now trying to fine tune their chitosan and antibiotic method of treating UTIs. He adds, “Our collaborators in Slovenia are in the beginning stages of trying to test chitosan in human patients. We have no data to report at this time, though.”

There are experts who do not share Blango’s optimism. Vivekanand Jha, professor of nephrology, PGIMER, Chandigarh, and secretary of Indian Society of Nephrology, says, “The method is very far from any clinical application and, in fact, may never come to that stage because there are a number of issues in terms of clinical delivery and applicability in the approach.” He does accept that a solution is needed.

“The biggest challenge is the emergence of resistant organisms, which means that the drugs that used to work well in the past are no longer effective,” says Jha. In the 1990s, the situation was not so bad and a case of uncomplicated UTI could be cured within three days, he says. But in the past 20 yearsÔÇêavailability of newÔÇêantibiotics, cheap generics and a complete lack of antibiotic policy have facilitated rampant antibiotic abuse. “In the past five years or so, the problem has reached alarming proportions,” says Jha.

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