A database focused on chronic urinary tract infections (UTIs) is set to support research into why women and girls experience infections that do not respond to treatment. Researchers state that UTIs may begin in childhood and continue for years without resolution.
Research indicates that UTIs that do not resolve with antibiotics may be linked to bacteria located within the bladder wall, allowing them to avoid immune response and treatment. This process is referred to as intracellular bacterial colonisation.
A case study led by researchers from the University of Sydney and published by the American Society for Microbiology examined a child with recurring infections. The study highlighted the scale of impact associated with intracellular bacterial colonisation.
The case study reported that antibiotic treatment did not clear the infection because bacteria were present within the bladder epithelium. Patient samples showed no change despite treatment over several years. The findings raise questions about current clinical pathways, which rely on antibiotics and diathermy, a surgical method using electrical heat to alter bladder tissue. Repeated use of diathermy is associated with a higher risk of cancer.
Dr Arthika Manoharan, lead researcher from the Charles Perkins Centre and the School of Medical Sciences, said that girls as young as five are treated with antibiotics for extended periods, with infections returning once treatment ends.
Following publication of the case study, the database led by Dr Manoharan will focus on children under the age of 15. The database aims to examine why some individuals develop chronic UTIs and to challenge the assumption that UTIs are linked to sexual activity, which researchers say has reduced attention on the condition in women and girls.
“Often people think of UTIs only affecting adult women who are sexually active, which is not the case. There are many cases where this issue starts in childhood, with no clear cause. This can have a huge impact to their quality of life at a time when they should be enjoying school, playing sports and simply being kids,” said Dr Manoharan.
“The longer consequences of persistent UTIs can be severe. Some women see their employment affected due to chronic incontinence; others are unable to maintain a sexual relationship. Many echo the same sentiment: One minute you’re fine, the next you’re in agony and can’t leave the house.”
The research team stated that the database may support investigation into immune response and genetic factors to explain differences in UTI development among children.