Abstract
Antimicrobial bacteria resistance is an important problem in children with recurrent urinary tract infections (rUTI), thus it is crucial to search for alternative therapies. Autologous bacterial lysates (ABL) may be a potential treatment for rUTI. Twenty-seven children with rUTI were evaluated for one year, urine and stool cultures were performed, 10 colonies of each culture were selected and those identified as Escherichia coli were characterized by serology. For patients who presented ≥105 UFC/mL, an ABL was manufactured and administered orally (1 mL/day) for a month. Twelve children were monitored for ≥1-year, 218 urine and 11 stool samples were analyzed. E. coli (80.5%) was the main bacteria isolated from urine and feces (72%). E. coli of classical urinary serotypes (UPEC), O25:H4, O75:HNM, and O9:HNM were identified in patients with persistent urinary infection (pUTI). In 54% of patients treated with ABL, the absence of bacteria was observed in urine samples after 3 months of treatment, 42% of these remained without UTI between 10–12 months. It was observed that the use of ABL controlled the infection for almost 1 year in more than 60% of the children. We consider it necessary to develop a polyvalent immunogen for the treatment and control of rUTI.
Highlights
Urinary tract infections (UTI) are an important cause of disease during childhood, the condition may be acute or chronic and it is an indicator of anatomical and functional anomalies [1,2]
Patients were monitored over a period of 2 to 39 months; at the beginning of the trial, 25 children reported cystitis, one reported pyelonephritis and another one asymptomatic bacteriuria
Sharma et al [44] using polyvalent sera were able to typify 44% E. coli strains isolated from patients with UTI, similar to the results reported here
Summary
Urinary tract infections (UTI) are an important cause of disease during childhood, the condition may be acute or chronic and it is an indicator of anatomical and functional anomalies [1,2]. E. coli strains have great genetic plasticity associated with the presence of different kinds of genes, which have contributed to the evolution of the bacteria through the generation of varieties of E. coli strains selected by environmental conditions. In this manner, there are strains defined as commensals that are part of the intestinal microbiota, other strains related to the etiology of intestinal diseases (DEC), and strains referred to as extraintestinal pathogens (ExPEC) [7,8]
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