Lauren Drage

Biomarkers to aid the management of elderly people with bacteriuria

Urinary tract infection (UTI) is one of the most common causes of bacterial infection with approximately 150 million cases in the UK each year, which is a huge financial burden on health care providers. If unsuccessfully treated the infection can reach the kidneys, and in serious circumstances, the blood, which can be fatal. Many patients suffer recurrent UTI where the bacteria are dormant in the bladder and can reactivate sporadically to cause symptomatic UTI. Between symptomatic infections patients have asymptomatic bacteriuria (ABU), where the bacteria continues to be present without causing symptoms. Currently ABU is poorly understood and can be often inappropriately treated with antibiotics, it is therefore crucial that we increase our accuracy of targeting treatment to those that need it for people with ABU/recurrent UTI and avoid harmful inappropriate use of antibiotics.

The aim of this research is to identify a specific combination and threshold of urinary biomarkers, which could guide treatment by staging the disease. Guiding treatment could prevent ineffective or excessive prescription of antibiotics, which may reduce selection for multi-resistant infections. Multi-resistance in UTI is especially important in the elderly population who can face many other complications during treatment.

We aim to characterise the potential combination of biomarkers for a monitoring test as well as validating these using in vivo testing of clinical isolates. To test the biomarker use in practice, a 6-month study will be completed on patients with asymptomatic UTIs over the age of 65. Regular urine samples will be collected to analyse selected biomarkers.

The current trend in the Biotech industry is an emphasis upon UTI diagnosis, leaving a gap in the market for disease monitoring and treatment optimisation. These results from this research may generate a potential patient-side test for better infection management. Such a test would have major impact upon the management of the many elderly patients suffering with this health problem.

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