“Remember, I was born before antibiotics,” she reminded me at the end of our conversation. Of course, that world is not so unfamiliar to Mann. Read: A bold new strategy for stopping the rise of superbugs In one way, drug-resistant recurrent UTIs are a glimpse into an antibiotic-free future. The failure of antibiotics and the lack of approved alternatives has driven patients to Facebook groups and Reddit forums, where they discuss unapproved cures such as apple cider vinegar and essential oils. Mann, for her part, has tried everything she can-from the doctor-ordered surgery that separated her colon and bladder wall to cranberry supplements to treatments like colloidal silver, which made her doctors wary. Mulvey thinks the bacteria may be able to enter dormant states to hide from antibiotics, and targeting this behavior might help treat these recurrent infections. coli kept surviving in the gut even when Mann’s UTI went away. But the genetic data suggest that some E. They prescribed a drug that worked, and her infection would clear. Whenever she went to the hospital with a UTI, her doctors cultured the bacteria from her urine and tested the bugs against various antibiotics. The study also got Mulvey to wonder why the same E. The effects seem to wear off at six months, suggesting the gut microbiome might need to be replenished regularly. Lane’s preliminary data on 10 patients found that the fecal transplants reduced UTIs at three months-but they were no silver bullet. “We’re definitely in need of new treatments,” says Lane, who led a small clinical study on fecal transplants in patients with recurrent UTIs. And the link, if real, points to another way to treat UTIs that has recently gained traction: fecal transplants. The study does not rule out the bladder as a reservoir for bacteria, but it does bolster a link between UTIs and the gut microbiome. Researchers debate whether bacteria that cause recurrent UTIs come from the bladder or the gut, says Felicia Lane, a urogynecologist at UC Irvine who was not involved in the study. Read: When gut bacteria betray their hosts But where was Mann getting the same strain from over and over again? The team decided to sequence Mann’s fecal samples too, and found a match: The bacteria causing her UTIs were also hiding out in her gut. coli known as ST131, commonly found in drug-resistant UTIs. Over a period of five years, Mulvey and his collaborators collected and sequenced urine samples from Mann when she got UTIs.Īll of Mann’s UTIs during that five-year period turned out to originate from a single strain of E. “I always feel bad,” he says, “because I feel very unable to help them.” But Mann was unusually persistent-as well as unusually nice, Mulvey says-and the relationship turned into a multiyear, single-patient study. Mulvey had published a few papers on bacteria that cause UTIs, and patients were frequently emailing him for help. In 2012, Mann got in touch with Matt Mulvey, a microbiologist at the University of Utah. She was frustrated and desperate and in pain. “They kind of give up on you because they don’t know what to do,” Mann said. And in these cases, doctors are finding it difficult to treat what were once easily cured infections. Mann’s case might be remarkable for its duration, but she is part of a growing and worrying trend: More and more UTIs are becoming resistant to antibiotics. She tries not to go anywhere she doesn’t know, because UTIs can lead to frequent and intense urges to urinate, along with pain, fatigue, headaches, and sometimes even a deadly infection of the kidneys.
![utterly useless crossword clue utterly useless crossword clue](https://pentesterhome.files.wordpress.com/2019/10/nez4.jpg)
“I know every bathroom in every place I shop,” Mann, who is 82 and lives outside Salt Lake City, told me. Now her recurrent UTIs are so frequent and so difficult to treat that she has to plan her life around them.
![utterly useless crossword clue utterly useless crossword clue](https://1.bp.blogspot.com/-rGU8Yzr_0B8/W6brb_cP6BI/AAAAAAAAkCU/JSL3en7vzL4wU94-v17gAyIQBN3waL3FACLcBGAs/s1600/tangle.jpeg)
Her UTIs became resistant to multiple antibiotics.
![utterly useless crossword clue utterly useless crossword clue](https://cdn.acidcow.com/pics/20210214/1613302180_dv02uv3n3x.jpg)
Repeat, repeat, repeat for more than 40 years-the list of treatments that worked against her infections getting shorter and shorter and shorter over time. She would take antibiotics and get better.
![utterly useless crossword clue utterly useless crossword clue](https://diariesofdawn.files.wordpress.com/2015/10/img_20150630_114938.jpg)
Nanell Mann began getting urinary tract infections in 1971, when she got a hysterectomy following the birth of her sixth child.