Intracellular bacterial communities (IBC) and recurrent urinary tract infections

Increasing prevalence of antibiotic-resistant uropathogenic E. coli (UPEC) together with the recognition of UPEC as intracellular pathogens confronts our current treatment regimens of urinary tract infections (UTI). During UTI, UPEC can invade epithelial cells, replicate and form intracellular bacterial communities (IBC) that evade neutrophils and conventional antibiotic treatment. The protected bacteria can later exit the host cell to re-infect the urinary tract and the presence of IBC in the bladder appears to be associated with increased risk of recurrent UTI.  

There is today no diagnostic tool that can identify patients who are carriers of intracellular bacteria in the bladder. These patients will exhibit a sterile urine culture despite that the urinary tract is colonized with intracellular UPEC. This project aims to identify urinary biomarkers for intracellular bacteria to be able to predict and diagnose individuals with recurrent UTI. By such knowledge the choice of antibiotics and treatment may be optimized to achieve better treatment results and reduce the risk of future recurrences. 

Further knowledge on how intracellular bacteria avoid the host response and understanding of why some host cells become invaded while some stay un-invaded are paramount in order to implement countermeasures. We are currently mapping the whole genome-wide responses of IBC-hosting epithelial cells and virulence factor genes of UPEC in order to gain crucial knowledge about mucosal response pathways of IBC-development in order to attenuate invasion and IBC-formation.