title: Repeated Treatments with Chitosan in Combination with Antibiotics Completely Eradicate Uropathogenic Escherichia coli From Infected Mouse Urinary Bladders.
abstract: Uropathogenic Escherichia coli (UPEC), the primary causative agents of urinary tract infections, colonize and invade the epithelial cells of the bladder urothelium. Infection of immature urothelial cells can result in the formation of persistent intracellular reservoirs that are refractory to antibiotic treatments. Previously, we defined a novel therapeutic strategy that used the bladder cell exfoliant chitosan to deplete UPEC reservoirs. However, although a single treatment of chitosan followed by ciprofloxacin administration had a marked effect on reducing UPEC titers within the bladder, this treatment failed to prevent relapsing bacteriuria. We show here that repeated use of chitosan in conjunction with the antibiotic ciprofloxacin completely eradicates UPEC from the urinary tract and prevents the development of relapsing bouts of bacteriuria. In addition, microscopy revealed rapid restoration of bladder integrity following chitosan treatment, indicating that chitosan can be used to effectively combat recalcitrant bladder infections without causing lasting harm to the urothelium.
authors.affiliation: Institute of Cell Biology, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Andreja
authors.initials: A
authors.lastname: Erman
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Veronika Križan
authors.initials: VK
authors.lastname: Hergouth
authors.affiliation: Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Blango
authors.affiliation: Faculty of Pharmacy, University of Ljubljana, Slovenia.
authors.forename: Mojca Kerec
authors.initials: MK
authors.lastname: Kos
authors.affiliation: Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Mulvey
authors.affiliation: Institute of Cell Biology, Faculty of Medicine, University of Ljubljana, Slovenia.
authors.forename: Peter
authors.initials: P
authors.lastname: Veranic
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001437:Bacteriuria / Q000188:drug therapy*; D048271:Chitosan / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D004927:Escherichia coli Infections / Q000188:drug therapy*; D005260:Female; D006801:Humans; D051379:Mice; D008810:Mice, Inbred C57BL; D012008:Recurrence; D001743:Urinary Bladder / Q000473:pathology; D056689:Uropathogenic Escherichia coli / Q000187:drug effects*; D019459:Urothelium / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D048271:Chitosan
keywords: UPEC; UTI; bacteriuria; chitosan; recurrent bladder infections; urinary tract infection; uropathogenic; urothelium