UTI research milestones — and future research needed

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Kate graduated with a B.A. in Journalism from San Diego State University. She is the Content Manager at Uqora and is responsible for Uqora's social media, newsletters and contributing to the UTI Learning Center.

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The last decade has brought many milestones in the world of UTI research. For one, it is marked by a sharp increase in the understanding of infections and antibiotics. In particular, we have faced with rising rates of antibacterial resistance, meaning that many antibiotics that were once incredibly effective against an infection — including a UTI — are becoming significantly less effective.

Going back to 2010, a study that was conducted by the Washington University School of Medicine in St. Louis has found that the intensity of UTIs has a lot to do with the body’s initial immune response to the invading bacteria. The researchers reported that the body’s immune response is different from individual to individual, and the severity of that response corresponds to more severe UTI symptoms. That same year, another study demonstrated that bacteria from meat like chicken, which may be resistant to some antibiotics, may be the cause of some UTIs. The researchers convincingly linked ingested meat with higher risks of UTIs among women.

Fast forward a couple of years, to 2012. Researchers at the Washington University School of Medicine in St. Louis published a study in which they found that bacteria leverage the body’s natural defense systems in order to stay alive. This research highlighted the incredible complexity of host-pathogen interactions, leading to more research on the topic.

The year 2014 brought the concept of antimicrobial resistance further to the forefront of the scientific community. The World Health Organization (WHO) published a global report highlighting the impact of bacteria that have become resistant to common antibiotics. The report outlined suggestions for how to take antibiotic resistance into consideration when treating conditions and infections. That same year, the Centers for Disease Control and Prevention (CDC) highlighted that nearly half of pregnant women were prescribed an antibiotic of concern to treat their UTIs. Also in 2014, researchers at the Stritch School of Medicine at Loyola University in Chicago publish a study that demonstrates that urine is, in fact, not sterile.

That study was bolstered by additional findings that disprove the sterility myth by the European Association of Urology in 2015. That same year, an immune protein, siderocalin, was found to be inversely proportional to the occurrence of UTIs. In other words, the protein’s presence in high concentrations indicated lower chances of UTI occurrence. That same study also demonstrated that a diet containing aromatics like polyphenols may be linked to decreased likelihood of getting a UTI.

A study published in 2017 found a connection between sexual activity and the recurrence of UTIs. The researchers at Washington University School of Medicine in St. Louis found that Gardnerella vaginalis, a vaginal bacteria, reactivates otherwise dormant E.coli from a previous infection to cause a new one. That same year, the WHO published a list of bacterial strains that are of highest concern. The WHO hopes this will lead to the development of antibiotics that would otherwise not receive enough attention and funding. That same year, $25,000 in funding was given to a student startup that focuses on developing a short-wavelength ultraviolet light device that destroys bacteria in catheters.

2018 saw an increase in focus on recurrent and chronic UTIs, and a push to reclassify these as something more than just ‘UTIs’. The bladder microbiome was analyzed by researchers in Australia who found that variability in the bladder microbiome contributes to some individuals being more prone to recurrent infections. In that same year, some light was shed on a cellulose molecule whose connection with bladder cells seems to play a key role in recurrent UTIs. From a diagnostic perspective, a study at the University College London urged for the development of more powerful diagnostic tools as the standard UTI tests, as standard urine cultures may be inadequate for the diagnosis of chronic UTI.

The year 2019 brought forth an article by The New York Times that labelled UTIs “the single biggest risk to healthy people from drug-resistant germs.” This not only highlighted the health crisis status of UTIs, but it triggered such a widespread response that The New York Times published a follow-up article. A scientific study that came out of the University of Queensland illustrated that treatment of persistent infections should be based on killing bacteria that are located in the intestinal tract as well as in the bladder. Also in 2019, an at-home urinalysis product was launched that may be able to provide helpful information on if individuals are at higher risk for developing a UTI. That same year, research shed light onto postmenopausal UTIs, and why these women are at an increased risk for recurrent UTIs. The research demonstrated that multiple strains of bacteria penetrate the bladder walls among postmenopausal women. Lastly, a study that was conducted at Newhaven University demonstrated that the body’s inflammatory response is critical in triggering severe chronic infections because the bladder is altered in such a way that the immune system will overreact in the future.

Here we have summarized some of the findings and discoveries over the last decade. However, much more research on UTIs, especially recurrent UTIs, is needed. We feel the focus of future research should seek to better understand the mechanism of UTIs such that they can be prevented, instead of relying on antibiotic treatment.

An example of this is Uqora’s new clinical trial, which seeks to expand research on urinary health and UTIs and make advancements in efficacious prevention options.