Buddy system: G. vaginalis triggers E. coli recurrent urinary tract infection

As mentioned in previous PLoSibilities blog posts, the body is inhabited by trillions of microorganisms, such as bacteria, viruses, fungi, and archaea. The bacteria in our bodies have already been extensively catalogued, in part because of pre-existing scientific methods for studying genetic relationships between different bacteria. While bacteria can be found all over and within the body, there are bacterial hotspots, such as the gut, the skin, the nose, and the reproductive systems. Each of these sites have unique bacterial compositions. The bacteria that live with us and help our body function are referred to as commensal bacteria. By contrast, pathogenic bacteria cause disease. Pathogenic bacteria can sometimes inhabit the body as silent passengers until they receive a signal to cause disease.

Millions of women worldwide are affected by urinary tract infections (UTIs). UTIs can impact the kidneys, ureters, bladder, and urethra, although most infections occur in the bladder and the urethra. Women are at a greater risk of developing UTIs than are men. UTIs account for 9% of antibiotic prescriptions handed out at doctor’s offices and clinics. UTIs can also reoccur following appropriate treatment. It is estimated that 70 million women worldwide experience six recurrent UTIs each year. Recurrent infections can be divided into two categories: relapses are when the same organism that caused the first infection causes the recurrent infection, and reinfections are when a different organism causes the reinfection. E. coli is the most common UTI-causing organism. Until recently, scientists did not know what triggered E. coli to cause UTIs.

In this paper, Gilbert et al. demonstrate that exposure to Gardnerella vaginalis, a bacterium common in the vaginal microbiome, is sufficient to trigger E. coli to cause a UTI. Moreover, they observed that exposure to G. vaginalis caused more severe UTIs by causing kidney damage. This research offers an exciting opportunity to investigate other possible UTI therapies. In recent years, there has been a global rise in multi-drug resistant E. coli. This research suggests that therapies targeting G. vaginalis may be an indirect route to preventing and treating UTIs.

Figure from Gilbert et al. article describing G. vaginalis triggering E. coli to emerge from reservoirs and cause disease. 

Summary written by: Emma Finlayson-Trick

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