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Antibiotic Resistant Urinary Tract Infection on the Rise

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Antibiotic resistant “superbugs” are a growing concern in all areas of health care. Methicillin Resistant Staphylococcus Aureus, or MRSA, is one of the deadliest. In a recent meta-analysis of 30 studies, the average mortality rate from MRSA infection was 36 percent.

Bacteria that are resistant to methicillin are also resistant to all other antibiotics in the beta-lactam class, which includes penicillin derivatives and cephalosporins. The only antibiotics available to kill MRSA are powerful and potentially toxic options such as vancomycin.

Most urinary tract infections (UTI) are caused by Escherichia coli. Staphylococcus aureus, both methicillin-resistant and methicillin-sensitive strains, are relatively rare. However, a study by Mayo Clinic showed that MRSA infections have almost tripled over the last decade. In 1997, only 3 per 1,000 urine cultures in their database were identified as MRSA. By 2007, the rate was 8 per 1,000.

Ordinary antibiotics are not only ineffective against MRSA, they can make the bacteria more virulent. There are two mechanisms for this effect: (1) the common antibiotics kill off other bacteria, clearing the way for MRSA to grow faster; (2) many antibiotics change the cellular chemistry of MRSA. The bacteria then increase production of Staphylococcal toxins, and switch on genes that cause MRSA to spread throughout the bloodstream. MRSA bacteria exposed to antibiotics also produce more of the molecules that cause adhesion to indwelling catheters.

Most antibiotics on the market today are derived from natural molecules that microbes produce, presumably to protect themselves from competition by other species. Genetic resistance to these antibiotics is to be expected; at least the microbe that produces the antibiotic must be resistant to it. Genetic material can be transferred from one species of bacteria to another in the form of plasmids and other sub-cellular units.

For natural options to prevent urinary tract infections, see

Good communication with your doctor is always important. When taking antibiotics for urinary tract infection, be sure to report any worsening of your symptoms immediately.

by Linda Fugate, Ph.D.


1. Dancer SJ, “The effect of antibiotics on methicillin-resistant Staphylococcus aureus”, Journal of Antimicrobial Chemotherapy (2008) 61, 246-253.

2. Routh JC et al., “Increasing prevalence and associated risk factors for methicillin resistant Staphylococcus aureus bacteriuria”, Journal of Urology 2009 Apr;181(4):1694-8.

3. Walsh CT and Fischbach MA, “New Ways to Squash Superbugs”, Scientific American, July 2009, 44-51.

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EmpowHER Guest

The Health Protection Agency (UK) said that new strains of bacteria, called Enterobacteriaceae, have been identified in UK hospital patients, a majority of whom was treated (plastic surgery, organ transplants) in India or Pakistan.

So closely linked are the bacteria to the Indian subcontinent that a strain has an enzyme identified as NDM-1 (New Delhi Metallo-1). The bacteria can arm other bacteria with this enzyme and may result in "Super Superbug" that spread all over in UK.

These bacteria are now in circulation since nine affected patients have no immediately identifiable overseas links. A total of 22 bacteria with the NDM-1 enzyme have been identified from 19 patients at 17 hospitals. One instance of possible transmission between two patients has also been identified.

The risk from infections which are more difficult to treat due as the recent emergence of a new group of enzymes (carbapenemases) carried by some bacteria is of concern because these enzymes prevent carbapenem (the only strictly controlled last antibiotics) working effectively, making the bacteria resistant.

August 20, 2009 - 12:43am
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