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Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder.

Publication ,  Journal Article
Balsara, ZR; Ross, SS; Dolber, PC; Wiener, JS; Tang, Y; Seed, PC
Published in: Infect Immun
August 2013

Neurogenic bladder predisposes to recurrent urinary tract infections (UTI) and renal failure, and susceptibility is commonly ascribed to urinary stasis from elevated residual urine volumes. Escherichia coli UTI was modeled in the spinal cord-injured (SCI) rat with the hypothesis that SCI animals would require fewer bacteria to establish infection, have an exaggerated inflammatory response, and have delayed clearance of infection compared to normal-voiding controls. T10 SCI rats and controls had median infectious doses (ID50) of 10(2) and 10(5) CFU, respectively. Mean residual volumes in the SCI animals did not correlate with susceptibility to initiation of UTI or outcome. In the acute infection, control and SCI rats developed acute cystitis and pyelitis without acute differences in histopathological scores of inflammation. However, in vivo imaging of infected animals revealed persistently higher levels of bacteria in the SCI urine and bladders than were seen for controls over 2 weeks. Likewise, at 2 weeks, acute and chronic inflammatory infiltrates persisted in the bladders and kidneys of SCI rats, whereas inflammation largely resolved within the controls. Together these data demonstrate that SCI rats exhibit delayed clearance of infection and exaggerated inflammatory responses in bladders and kidneys; however, the severity of residual volumes does not predict increased susceptibility to UTI. These studies suggest that host-dependent mechanisms that are discrete from alterations in bladder physiology influence UTI susceptibility with the SCI-neurogenic bladder. This model will allow elucidation of SCI-neurogenic bladder-mediated changes in host response that yield UTI susceptibility and may lead to new preventative and therapeutic options.

Duke Scholars

Published In

Infect Immun

DOI

EISSN

1098-5522

Publication Date

August 2013

Volume

81

Issue

8

Start / End Page

3018 / 3026

Location

United States

Related Subject Headings

  • Urinary Tract Infections
  • Urinary Bladder, Neurogenic
  • Spinal Cord Injuries
  • Rats, Sprague-Dawley
  • Rats
  • Microbiology
  • Female
  • Escherichia coli Infections
  • Escherichia coli
  • Disease Susceptibility
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Balsara, Z. R., Ross, S. S., Dolber, P. C., Wiener, J. S., Tang, Y., & Seed, P. C. (2013). Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder. Infect Immun, 81(8), 3018–3026. https://doi.org/10.1128/IAI.00255-13
Balsara, Zarine R., Sherry S. Ross, Paul C. Dolber, John S. Wiener, Yuping Tang, and Patrick C. Seed. “Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder.Infect Immun 81, no. 8 (August 2013): 3018–26. https://doi.org/10.1128/IAI.00255-13.
Balsara ZR, Ross SS, Dolber PC, Wiener JS, Tang Y, Seed PC. Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder. Infect Immun. 2013 Aug;81(8):3018–26.
Balsara, Zarine R., et al. “Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder.Infect Immun, vol. 81, no. 8, Aug. 2013, pp. 3018–26. Pubmed, doi:10.1128/IAI.00255-13.
Balsara ZR, Ross SS, Dolber PC, Wiener JS, Tang Y, Seed PC. Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder. Infect Immun. 2013 Aug;81(8):3018–3026.

Published In

Infect Immun

DOI

EISSN

1098-5522

Publication Date

August 2013

Volume

81

Issue

8

Start / End Page

3018 / 3026

Location

United States

Related Subject Headings

  • Urinary Tract Infections
  • Urinary Bladder, Neurogenic
  • Spinal Cord Injuries
  • Rats, Sprague-Dawley
  • Rats
  • Microbiology
  • Female
  • Escherichia coli Infections
  • Escherichia coli
  • Disease Susceptibility