Many older women struggle with urinary tract infections, and researchers now think they know why.
A big reason is that their bladder walls can be invaded by several species of bacteria, a recent study found.
Urinary tract infections (UTIs) are among the most common type of bacterial infections in women, accounting for nearly 25% of all infections. UTI recurrence rates can range from 16%–36% in younger women to 55% in postmenopausal women.
Researchers at University of Texas Southwestern (UTSW) in Dallas analysed bacteria in bladder biopsies from 14 postmenopausal women with recurrent UTIs. The investigators found that in these patients, several species of bacteria can get inside the bladder's surface area.
Diverse types of bacteria
Bacterial diversity, antibiotic resistance and immune response all play significant roles in recurrent UTIs, according to the scientists.
"Our findings represent a step in understanding [recurrent] UTIs in postmenopausal women," senior study author Kim Orth said in a university news release. Orth is a professor of molecular biology and biochemistry at UTSW.
"We will need to use methods other than antibiotics to treat this disease, as now we observe diverse types of bacteria in the bladder wall of these patients," Orth added.
UTI is the most common reason for antibiotic prescriptions in older adults. The high rate of UTIs has a significant social impact, and treatment costs billions of dollars a year, the study authors noted.
Recurrent UTI "reduces quality of life, places a significant burden on the healthcare system, and contributes to antimicrobial resistance," Orth said.
Other factors believed to contribute to higher UTI rates in postmenopausal women include pelvic organ prolapse, diabetes, lack of oestrogen, loss of Lactobacilli in the vagina, and higher levels of E. coli in tissues surrounding the urethra, according to the researchers.
The report was published in the Journal of Molecular Biology.
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