Gabe Mirkin, M.D.
When I was in medical school more than 45 years ago, I
learned that E. Coli, a common intestinal bacteria, causes
recurrent urinary tract infections in women; and that women with
these infections should be given 100 ampicillin pills and be told
to take one pill four times a day for three days, whenever they had
symptoms: burning on urination or unreasonable urgency or frequency.
They were also told to take one ampicillin pill before making love.
Dr. Joe Palermo of Washington University in St. Louis
has found out why some women get urinary tract infections over
and over again, in spite of the best medical treatment available
today (Science, July 2003). He shows that the treatment I have
been prescribing for more than 40 years is correct. Dr. Palermo
showed in studies on mice that bacteria that cause bladder
infections gather into fort-like pods that keep out antibiotics. The
E. coli bacteria burrow into the cells that form the interior of the
bladder, which helps them escape not only antibiotics but also
the bladder's mechanism for keeping itself clean by shedding a
thin layer of cells. Every so often these pods break open,
releasing bacteria, causing inflammation and the symptoms of
bladder infection.
The pods are similar, but not identical, to other
communities of bacteria called biofilm which help protect bacteria
that cause cavities in your teeth. This same effect that causes
recurrent bladder infections, and recurrent cavities in teeth, may
also be responsible for recurrent infections elsewhere in the body
including children who suffer recurrent ear infections.
May 1, 2006