Urinary tract
infections (UTIs) affect anywhere from 25% to 60% of women over the
course of their lifetime, and hospitalization rates for UTIs in the U.S.
rose by 52% between 1998 and 2011 as a result of increasing
antimicrobial resistance
Researchers
have found the reason UTIs tend to have such a high recurrence rate in
postmenopausal women is because the infection can be caused by several
different pathogens that are deeply embedded in the tissue, making them
more resistant to elimination
In addition to
E. coli, bacteria in urine samples included Klebsiella pneumoniae and
Enterococcus faecalis, and species in biopsied tissue included E. coli,
Staphylococcus hominis and Bacillus firmus
About 80% to
90% of UTIs are caused by E.coli, which is normally found in your
intestinal tract. Problems only arise when this ordinary bacterium is
present in high numbers in your urinary system
Recent studies
have conclusively demonstrated that a majority of UTIs are caused by
exposure to contaminated chicken; American, Canadian and European
studies have all confirmed close genetic matches between drug-resistant
E. coli collected from human patients and those found on poultry
Urinary tract infections (UTIs) affect anywhere from 25%1 to 60%2,3
of women over the course of their lifetime. According to research
published in 2015, UTIs were responsible for 10.5 million doctor visits
in the U.S. in 2007.4
A study5
published in the journal Open Forum Infectious Diseases in 2017 noted
hospitalization rates for UTIs in the U.S. rose by 52% between 1998 and
2011 — a direct result of increasing antimicrobial resistance.
According to this study, there were 400,000 UTI-related
hospitalizations in 2011, with an estimated cost of $2.8 billion. The
highest rates of increase were seen in women and older patients.
In the past, recurrent UTIs were thought to be caused by reinfection by the same pathogen,6 but recent research7,8,9
published in the Journal of Molecular Biology suggests this pattern
has changed, and the reason why UTIs tend to have such a high
recurrence rate in postmenopausal women is because the infection can be
caused by several different pathogens.
According to the authors, the data uncovered via urine and bladder
biopsies "suggest that diverse bacterial species and the adaptive
immune response play important roles" in recurrent UTIs.
Pathogenic Mechanisms of UTIs
Women are more prone to urinary tract infections than men, in part
because of their shorter urethras. Adult men have another factor going
for them. The male prostate gland actually produces a bacterial growth
inhibitor that is secreted directly into their urinary system.10
According to research11
published in 2015, several different pathogens can trigger a UTI; most
commonly Escherichia coli (E.coli), Klebsiella pneumoniae, Proteus
mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus. Of these, about 80% to 90% are caused by E.coli,12,13 which is normally found in the intestinal tract.14
Problems only arise when this ordinary bacterium is present in high
numbers in places where it shouldn't be, like your urinary system. When
E. coli gets into your urinary tract and multiplies, you experience
the usual signs and symptoms of a UTI, such as:15
The reason your body cannot simply expel the E. coli through
urination is because the bacteria are covered with tiny fingerlike
projections called fimbria, made of an amino acid-sugar complex, a
glycoprotein called lectin, which makes them sticky.
This stickiness allows the bacteria to adhere to the inner wall of
your bladder and/or work their way upward toward your kidneys, at which
point the situation can become quite serious.
Sepsis is another complication of untreated or unsuccessfully treated
UTI (which can happen if the infection is caused by drug-resistant
bacteria), which can be life threatening. Intravenous vitamin C with
hydrocortisone and thiamine has been shown to reduce mortality from sepsis nearly fivefold, but many health care professionals are still unaware of this revolutionary treatment.
In addition to the symptoms already mentioned, a UTI in an older
individual can also result in sudden behavioral changes such as
restlessness, agitation, lethargy or social withdrawal, mental
confusion and even hallucinations and delirium.16
According to Dr. Amanda Smith, medical director at the Byrd
Alzheimer's Institute at the University of South Florida, symptoms of
UTI in the elderly actually tend to be primarily behavioral,17
which can result in delayed diagnosis and treatment. So, doctors of
elderly patients exhibiting these kinds of behavioral symptoms,
especially when combined with low-grade fever, should have them checked
for UTI.18
Advertisement
Recurrent UTIs Linked to Variety of Pathogens Deeply Embedded in Bladder Wall
What the Journal of Molecular Biology study discovered was that
different types of bacteria form colonies deep in the tissue of the
bladder wall, past the urothelium layer in many cases, making them very
difficult to get rid of. As noted by Science Daily, which reported the
Journal of Molecular Biology findings:19
"[F]or some postmenopausal women, UTIs recur so frequently that
they become a chronic condition, requiring daily doses of increasingly
powerful antibiotics as the infection-causing bacteria gradually become
resistant to each new drug.
'For older women, these infections can go on for tens of years,'
said Dr. Nicole De Nisco, assistant professor of biological sciences
at UT Dallas and lead author of the study. 'Eventually, a patient's
last resort might be removing the bladder' …
To investigate the pathogenic mechanisms and immune responses
related to recurring UTIs, De Nisco and her colleagues analyzed urine
and biopsies from 14 postmenopausal women …
They found that in addition to the expected E. coli, bacteria in
urine samples included Klebsiella pneumoniae and Enterococcus faecalis,
while species in biopsied tissue included E. coli, Staphylococcus
hominis and Bacillus firmus.
'Our findings confirm that bacteria do form communities within
the bladder wall of RUTI [recurrent UTI] patients, which was not
previously known,' De Nisco said. 'This research is a critical step
toward better understanding the mechanisms of recurring urinary tract
infection and inflammation in postmenopausal women' …
Future studies will focus on determining effective techniques to
remove these bacteria and chronic inflammation from the bladder,
finding new strategies to enhance immune system response, and
pinpointing the various bacterial pathogens involved in RUTIs."
Factory-farmed Chicken — The Leading Source of UTI Infections
Conventional wisdom has maintained UTIs are primarily caused by a
transfer of naturally-occurring E. coli via sexual contact with an
infected individual and/or the transfer of fecal bacteria from your
anus to your urethra by poor personal hygiene. However, more recent
studies have conclusively demonstrated that a majority of UTIs are actually caused by exposure to contaminated chicken.20
Importantly, factory-farmed chickens
are the source of most antibiotic-resistant UTIs — a problem that can
be traced back to the routine use of antibiotics for growth-promotion
purposes, which has allowed resistance to develop. Drug-resistant E.
coli strains from supermarket meat were matched to strains found in
human E. coli infections as early as 2005.21
Research22,23
published in 2006 confirmed that humans could develop antibiotic
resistance by eating poultry treated with antibiotics. Bacteria from
conventional chicken, and those who ate such chicken, were found to be
more prone to developing resistance against Synercid (generic names:
quinupristin and dalfopristin24), a strong antibiotic used to treat vancomycin-resistant Enterococcus faecium.25
In essence, eating antibiotic-treated chicken can cause you to
develop resistance to the last lines of defense currently available in
the modern medicine cabinet — a steep price for inexpensive meat! As
reported by Infectious Control Today:26
"Laboratory tests showed that the bacteria isolated from
patients and vegetarians had no pre-existing resistance to Synercid.
Resistance was rare among antibiotic-free poultry, but a majority of
bacterial isolates from conventional poultry samples were resistant.
After exposure to virginiamycin, E. faecium from conventional
poultry and from patients who consumed poultry became resistant to
Synercid more often than E. faecium from vegetarians or from
antibiotic-free poultry.
Some of the resistance was attributed to a specific gene, and
both the gene and resistance were associated with touching raw poultry
meat and frequent poultry consumption."
Genetic Matching Links UTIs to Contaminated Chicken
American, Canadian and European studies27,28,29
published in 2012 all confirmed close genetic matches between
drug-resistant E. coli collected from human patients and those found on
poultry (chicken and turkey).
More recently, a study30
published in the journal mBio in 2018 found 79.8% of chicken, pork and
turkey samples purchased from large retail stores in Flagstaff,
Arizona, were contaminated with E. coli. The researchers also tested
blood and urine samples from people who visited a major medical center
in the area, finding E. coli in 72.4% of those diagnosed with a UTI.
In particular, a strain of E. coli known as E. coli ST131 showed up
in both the meat samples (particularly poultry) and the human UTI
samples. Most of the E. coli in the poultry was a variety known as
ST131-H22, which is known to thrive in birds. This specific strain was
also found in the human UTI samples.
"Our results suggest that one ST131 sublineage — ST131-H22 — has
become established in poultry populations around the world and that
meat may serve as a vehicle for human exposure and infection," the
researchers noted, adding that this E. coli lineage is just one of many
that may be transmitted from poultry and other meat sources to people.
When Buying Chicken and Eggs, Make Sure They're Organic and Free-Range
While findings such as these are a potent reminder to use caution
when handling raw chicken and to cook poultry thoroughly, another
option — and perhaps the most sensible and rational approach is to
avoid factory-farmed chicken altogether.
It's easily among the most contaminated foods in the U.S., as a
recent lawsuit against the U.S. Department of Agriculture for failing
to address high rates of fecal bacteria on chicken can attest to. Factory-farmed chicken also has a weak nutritional profile compared to other protein sources, including pasture-raised chicken (which is also less likely to carry harmful contaminants).
For example, a study31,32,33
by the American Pastured Poultry Producers Association (APPPA), which
compared the nutrient value of pastured chickens with the USDA's
National Nutrient Database for Standard Reference values for CAFO
chicken, found pasture-raised chickens contained:
406.8% more vitamin E (1.86 IUs per 100 grams compared to 0.367 IUs)
About half the fats of CAFO chicken (saturated, monounsaturated and polyunsaturated)
An average omega-3-to-6 ratio of 1-to-5, which is near ideal, compared to the USDA's value of 1-to-1534
Considering the hazards associated with raw chicken, if you're going
to eat it, I recommend making sure it's organic and free-range,
pasture-raised. Ditto for eggs, as CAFO eggs are also far more prone to
pathogenic contamination than organic pastured eggs.
Your best bet is to find a local source of organic, free-range eggs and chicken meat. The Cornucopia Institute's egg report and scorecard ranks 136 egg producers according to 28 organic criteria, is an excellent resource if no local producers are available.
In June 2017, Cornucopia also began working on a chicken report and
scorecard. Considering the egg report took six years to produce, it may
still be a while before the chicken scorecard is ready. You can
contribute to this report by following the simple instructions listed
in their June 13 Action Alert.35
How to Treat a UTI at Home
As mentioned earlier, the fimbria (fingerlike projections) of E. coli are made of a sticky glycoprotein called lectin,
which is why the bacteria are so hard to flush out. It's not
impossible however, even without an antibiotic. While antibiotics are
typically the go-to treatment, you may be better off starting out with a
D-mannose supplement.36
Mannose is produced by your cells and covers the internal lining of
your urinary organs. The lectin on the bacteria's fimbria binds to
mannose, which is why the bacteria adhere to the walls of your urinary
system.
When you take D-mannose, the E. coli adheres to the mannose present
in your urine, which is then flushed out when you urinate. As the
bacterial load on epithelial cells lessen, they're more easily
overtaken by agents of your immune system.
Infections caused by a bacterium other than E. coli may be eliminated
by taking a saturated solution of potassium iodide (SSKI). Both of
these treatments are recommended by Dr. Jonathan Wright, medical
director of Tahoma Clinic in Tukwila, Washington, and the author of the
book, "D-Mannose and Bladder Infection: The Natural Alternative to
Antibiotics."
For UTIs caused by bacteria or fungi other than E. coli, Wright
suggests taking 15 drops of SSKI in water every three to four hours for
two days (three days maximum).37
In order to know which of these treatments would work best, you'd need
to perform a culture test to identify the bacteria responsible for your
infection.
Alternatively, Wright suggests taking D-mannose first, and if
significant improvement doesn't occur, move on to SSKI. A culture test
is also advisable to rule out a drug-resistant infection, as this will
require close medical supervision to avoid serious complications.
UTI Prevention 101
Prevention is, of course, your best option, and as a woman, there
are some specific hygiene steps you can take to maintain a healthy
urinary tract:
Drink plenty of pure, filtered water every day
Urinate when you feel the need; don't resist the urge to go
Wipe from front to back to prevent bacteria from entering your urethra
Take showers instead of tub baths; avoid hot tubs/Jacuzzis
Cleanse male and female genital areas prior to sexual intercourse
Avoid using feminine hygiene sprays, which may irritate your urethra
Use a bidet
In addition, a healthy diet is key in supporting your urinary tract. You can learn the key basics in my free online nutrition plan. Research38
has shown probiotics — especially Lactobacillus rhamnosus GR-1, L.
reuteri RC-14, L. casei shirota and L. crispatus CTV-05 — can prevent
UTIs. Fermented foods such as kefir, sauerkraut and other fermented
vegetables are great for your overall health, including your urinary
system.
Lastly, but perhaps most importantly, consider ditching all
factory-farmed chicken from your menu. At this point, there's little
doubt that chicken raised in concentrated animal feeding operations
(CAFOs) are a core component of the growing problem that is antibiotic
resistance in general, and UTI infections in particular.
Essentially, by using antibiotics, CAFO birds end up driving a cycle
of antibiotic use in human medicine as well, as UTIs are typically
treated with antibiotics. But aside from being a source of
antibiotic-resistant bacteria, and a primary route of UTI infections,
there are other reasons to avoid CAFO chicken as well.
In my interview with Maryn McKenna, author of "Big Chicken: The
Incredible Story of How Antibiotics Created Modern Agriculture and
Changed the Way the World Eats" (embedded above for your convenience),
she discusses many of the aspects of the chicken industry that many are
still unaware of.
As explained by McKenna, chickens were historically rather scrawny
little birds that no one thought to consume as a primary meal on a
regular basis. The chicken we eat today bear almost no resemblance to
the backyard chickens of old, as they've been specifically bred for
meat.
A nationwide contest called "The Chicken of Tomorrow Contest," which
took place in the 1940s into the early '50s, led to breeders reshaping
the scrawny barnyard chicken into the breast-heavy bird we're familiar
with today, and a Republican campaign ad for Herbert Hoover, carrying
the slogan "A Chicken for Every Pot," eventually turned chicken meat
into a household staple.
Today, chicken production
in the U.S. has become an industry that places profits over just about
everything else, including animal welfare and farmer's rights.
Precision breeding turned the boisterous barnyard chicken into an
exceptionally docile animal that didn't (indeed couldn't) move much.
These new traits allowed farmers to cram the animals together in tight
spaces.
Today, commercial chickens are raised in giant warehouses the length
of a football field, which can house 25,000 to 35,000 chickens at a
time. There, they live in artificial daylight, with an artificially
shortened night. Lack of space prevents them from moving about much
and, on average, they only live 42 days. So, avoiding CAFO chicken not
only protects your own health, it also encourages the humane treatment
of animals.
In contrast, organic, free-range chickens are allowed to engage in
their natural behavior in a natural environment (outdoors), and can
serve an important role in regenerative agriculture
and holistic land management. The lack of stress, access to a natural
diet, fresh air and sunshine, makes for healthier birds that don't need
antibiotics.
No comments:
Post a Comment