Bladder catheterization improves bacterial interference with asymptomatic Escherichia coli 83972 in an experimental porcine model of urinary tract infection.

Urinary tract infection (UTI) is a common disease with a significant risk of relapse. Deliberate bladder colonization with asymptomatic Escherichia coli is being explored as a potential strategy to fend off invading uropathogens thereby mitigating the risk symptomatic UTI. Currently, one major obstacle is the low success rates for achieving persistent bladder colonization with asymptomatic bacteria and experimental challenge studies are lacking. Here, we assessed the influence of an indwelling bladder catheter on the ability of asymptomatic E. coli to colonize the bladder and to assess the protective efficacy of such colonization against experimental urinary tract infection with uropathogenic E. coli.

Pigs with or without indwelling bladder catheters were experimentally inoculated with the asymptomatic E. coli strain 83972 and subsequently challenged by inoculation with the uropathogenic E. coli isolate, UTI89. The animals were monitored with regular urine and blood samples and bladders and kidneys were harvested at termination.

All pigs with indwelling catheters were colonized by 83972 in response to inoculation, compared to pigs without catheters in which only one of eight animals were colonized. When removing the catheter, 83972 were spontaneously cleared. Colonization with 83972 prevented experimental infection in 50% of animals compared to controls that all became infected.

The presence of indwelling bladder catheters strongly facilitates the colonization of 83972, indicating that individuals using catheters may be particularly suited for receiving this treatment. The research supports prophylactic colonization with 83972 as a potential strategy to reduce the risk of urinary tract infections.

The Journal of infectious diseases. 2024 Aug 20 [Epub ahead of print]

Kristian Stærk, Karin Andersen, Jannie Søvsø Hjelmager, Louise Kruse Jensen, Benjamin Meyer Jørgensen, Jakob Møller-Jensen, Lars Lund, Thomas Emil Andersen

Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Pathobiological Sciences, University of Copenhagen, Copenhagen, Denmark., Department of Biomedicine and Molecular Biology, University of Southern Denmark, Denmark.