E. Coli That Cause Urinary Tract Infections are Now Resistant to Antibiotics

By Veronique Greenwood | May 2, 2012 11:46 am


Thanks to antibiotics, we tend to think of urinary tract infections as no big deal. Pop some cipro, and you’re done. A good thing, too—if the E. coli that usually cause UTIs crawl up the urinary tract, they can cause kidney failure and fatal blood poisoning.

But antibiotics may not be saving us from UTIs for very much longer. Scientists tracking UTIs from 2000 to 2010 found a dramatic uptick in cases caused by E. coli that do not respond to the drugs that are our first line of defense. In examining more than 12 million urine analyses from that period, they found that cases caused by E. coli resistant to ciprofloxacin grew five-fold, from 3% to 17.1% of cases. And E. coli resistant to the drug trimethoprim-sulfame-thoxazole jumped from 17.9% to 24.2%. These are two of the most commonly prescribed antibiotics used to treat UTIs. When they are not effective, doctors must turn to more toxic drugs, and the more those drugs are used, the less effective they in turn become. When those drugs stop working, doctors will be left with a drastically reduced toolkit with which to fight infection.

Some of this growing resistance in E. coli and other bacteria is due to the fact that antibiotics are being overprescribed, handed out to patients who have no bacterial infections. There is also evidence that the genes that give bacteria resistance to drugs are being spread in livestock farming operations, where antibiotics are a common ingredient in animal feed. Ciprofloxacin is one of those antibiotics, and researchers have found that E. coli resistant to it are thriving in poultry farms. Very closely related strains of drug-resistant E. coli have been found in people, suggesting that the bugs spread from the birds to humans.

In this chart from the report, the trends in resistance are clear.

People suffered from UTIs long before antibiotics were discovered in the early twentieth century, of course. Should these drugs cease to be effective, we’ll have to go back to what we were doing before. The truth is, though, before antibiotics we had no real treatment. Sicknesses resembling UTIs have been described in medical texts for thousands of years, by everyone from the ancient Greeks and Chinese to the pioneers of evidence-based medicine in the early 1900s. Some of these doctors prescribed various tinctures, ointments, and special diets to deal with the symptoms, but in cases in which the infection spread to the bladder and kidneys and beyond, they were fairly helpless. As a last-ditch effort, they operated to drain puss from the infected kidneys and hoped the patient would survive. Treatment did not fundamentally change until antibiotics arrived on the scene.

In a world without antibiotics, many peoples’ UTIs would doubtless subside under attack from the immune system. But some fraction of them would not, and those people would find themselves in dire straits. And about the common idea that cranberry juice can prevent or treat UTIs: evidence is pretty spotty. Better to try to reduce the irresponsible use of antibiotics than rely on juice.

Image courtesy of somegeekintn / Flickr

CATEGORIZED UNDER: Health & Medicine, Top Posts
  • http://kforcounter.blogspot.com Cody

    What about bacteriophages? Don’t they potentially offer an alternative course of treatment, one that could even potentially evolve alongside our bacterial adversaries?

  • Victoria Kostadinova

    The whole mass livestock production system is frightening in it’s abuse of animals, resources, and a plethora of chemicals and drugs. It’s nothing but trouble happening now, and unimaginable trouble waiting to happen. We all need to demand that our meat is raised responsibly. Buy local and organinc from small farmers you know and trust. Your everyday choices do matter, and letters to the USDA help too.

  • Robert

    Very few antibiotic will help with urinary tract infection caused by certain strains of e.coli. Non will help with ESBL strain of this bacteria. Overuse of antibiotics is main cause of development of suberbugs such as MRSA or ESBL that are resistant to any known antibiotic.
    Recommended alternative solutions such as cranberry products, or d-mannose will help just to the certain point with very week infections of 10000 or less bacterias per ml.
    Two natural products that actually have significant impact on strong UTI caused by e.coli are Croatian E-kapi, and Canadian product called E-Drops Nano. Both contain extract from juniperus communis with mixture of other herbs that have very strong antibacterial properties. I had opportunity to practice in North America and Europe, and I did witness both product eliminating infections where multiply antibiotics failed !

  • http://www.darthcontinent.com Darth Continent

    @Cody: It seems puzzling that bacteriophage technology hasn’t become more popular here in the U.S., at least. The Russians successfully used them to combat infection even as far back as WW2. I guess pharmaceutical companies want to squeeze as much as they can out of increasingly expensive antibiotics while they can, then at some critical juncture they might finally adopt it in earnest. I would hope this would happen sooner; having the ability to custom-tailor a virus to attack a particular strain of E. coli or whatever bacterium without harming the host seems like the ideal way to combat infection.

  • John Lerch

    “…juniperus commnuis…” I guess I’ll be drinking more of my gin and tonics.

  • coryy

    There is some evidence that D-Mannose can help prevent the E. Coli from adhering the the bladder and urethra lining…I’m hoping, anyway, as I have a daughter with recurring UTI’s and she’s been on and off antibiotics for 3 years now. Fortunately for her the infections are mostly the painless kind, but we have resorted to simply allowing her to live with all but the worst infections as testing showed that the bugs were becoming resistant.

  • Scott

    Victoria, the world you describe is a fairyland. Food is industrialized because it is cheaper. If you want small organic raised chicken, it’s available for you to buy, but don’t suggest asking the USDA to make meat more expensive than the poor can afford. I don’t know any farmers though I’m sure I am as likely to find a trustworthy person working in the current food industry. You should just have platitudes for breakfast instead.

  • gwen

    Robert, one must remember, anecdote doth not equal evidence. You don’t know that the immune systems of these people did not eventually rid them of the infection, and in testing, cranberry juice has been found ineffective as anything more than a placebo.

  • Phil S

    – And now we have NDM-1 in circulation things have just become that bit more exciting. It’s not just inappropriate use and over-use, it’s what happens when you excrete your doses of antibiotics – and they arrive at the Waste Water Treatment plants, nicely diluted to very sub-lethal concentrations, and just what the vast and biodiverse Gram-ve populations in these water management plants like to thrive on. THIS is where the problem is, and so far even “Tertiary Treatment” systems have failed to address this major problem of resistence generation and communication.

    For the majority of the Population, it’s the old story of “Out of sight, out of mind”, but this complacency is going to affect Medicine really badly in the future.

  • AK

    I have had recurring UTI since last 3 months. I have not had any antibiotices since last 13 years now however the identified strain was multidrug resistant including Cipro, Ofloxacin and Sulphamethoxazole inclding 9 other drugs. The next course of action is now intravenous Fosomycin. UTI out of nowhere…..

  • Meaghan W

    I wonder if this affects young healthy people as much as it affects 90 year olds laying in hospital beds waiting to die getting hospital acquired infections.

  • Uwe

    E. coli causing UTI use receptors on the host cell surface to bind, in some cases this binding can be inhibited or reduced by the use of D-mannose. Essentially the E. coli binds to the D-mannose and not the receptor on the hosts tissue. However, not all E. coli strain binding will be inhibited by this, it depends on the strain. These sorts of studies have been done in the 80s.

  • Pam

    At coryy: I was in a round of antibiotics for 2 years on and off constantly for my UTI’s. Finally after a long search (still do it sometimes like today) I decided enough was enough. I started reading and searching in internet about natural ways to kill this E. Coli thing. I tried everything from D-masone through canberry and everything I could read. Finally I went dip into food. I learned the E. Coli lives with sugar!!!!! so that’s the big thing the big problem, you can kill it or keep it sleeping for years. I did it for 1 year without antibiotics. I complete change my way to eat. I went more green and organic. Saladas with raw veggies, and soup heavy soups cause I like to eat… a lower my read meat a lot, and eat more breast chicken, fish and protein’s vegan (hemp)…anyway, no sugar as well no carbohydrates no fruits cause is sugar, also I did not quit my saturdays tequila :)…. anyway it was a complete change, then started a cleanse with physillum and benzonite for 4 or more, then antibacterial (oregano oil and then grapefruit seed) to kill everything…. and woola! 1 year without UTi’s and no antibiotics…. but someday after 1 year I got it again …. why cause I was losing too much weight and decide to start eating again carbohydrates (love pastas) more read meat to recover some weight and then have a night of crazy sex and woola, UTI back again…… went to the doctor and of course, I told the doctor give me a time to heal this by myself ….. now the thing that works for me is Collidial silver, I drink it at first sign….. I insert myself a tampon with some drops of it and drinking also for 7 days….. then of course very important probiotics (femdophilus) double portion and food, alkaline food, yogurt with alive cultures, water with lemon all the time you can add some cayane pepper ………hope it helps you, but I believe everything is how you eat…. you can heal yourself with food and help of natural antibiotics which will not take away your inmune system…

  • Karen Padusis

    I ended up with a kidney infection trying to find a natural way to get rid of my UTI. I agree with Pam with diet. I haven’t been doing any fruit/sugar for over thirteen years though not only because of UTI’s.

    As far a placebo effect, might be for some but not for me. Something ether works or it does not. I have had numerous UTI’s to know they don’t go away by themselves but get much worse without treatment. I have yet to find any alternative treatment, including diet alone but certainly helpful that works for me. Antiboitics were the only thing that helped. Thank God for them. I know this might not be the case for many.

    I recently got another UTI last month. I tried more alternative treatments but to no avail. Collidail silver has never gotten rid of any infection with me. I’ve tried many forms. Yet, others claim it’s miraculous effects.

    I might try Roberts suggestions as I haven’t been down that road before. I was started on a regime of Cipro again which usually works but this time it isn’t helping. I just received a phone call from my doctors saying my culture came back with a type of infection that is resistant to Cipro. So they are going to try something else.

    Excess sugar, stress, poor diet can make any health issue worse. Still, I am grateful not having the burning pain. I also make sure I urinate after sex with my husband no matter how fatigued I feel. It seems to mostly occur then.

    I usually don’t read blogs but many intelligent replies along with great info.

    Hope this new antibiotic helps. Until then, i will keep trying new treatments.

  • Marie

    I have had this UTI now also for at least 8 months … didn’t take it too seriously at first because I too have the kind that does not hurt … but itches like crazy …that is the most discomfort I have all the time.

    However 4 weeks ago I was hospitalized for crohns disease and had surgery to remove (for the second time) some diseased intestines.

    While there ; the very first day of tests they also discovered I had a UTI …and began to treat me with mega doses of powerful antibiotics through an IV …however , I left 10 days later still with the UTI …

    my GP just called to say the test I had on Friday came back positive for (still) a UTI and he was sending a script for amoxecillen to the pharmacy – from what I have just learned from news about the chickens and women and this forum …it doesn’t seem like amoxicellin would be of any value ??

    So , do I call the doc tomorrow and ask that he do more tests to see what strain this is ? How do they do that or even know ?
    Thanks, !

  • http://www.usingdmannose.co.uk Pat

    Marie, have a look at websites http://www.waterfall-d-mannose.com and http://www.sweet-cures.com. This firm also sells an oregano medication too. It’s based in York, U.K. The staff are very knowledgeable, understanding and kind.
    Anna, one of the two directors, had such severe cystitus that the infection had travelled to her kidneys. After fiendish operations and ‘remedies’ that didn’t work, she was told that she would lose her kidneys and be on dialysis for the rest of her life.
    After a lot of research she discovered websites in U.S. re D-mannose, a natural sugar that comes from larch trees. Sadly it had a lot of additives and though it got rid of some of the bacteria it wasn’t enough.
    So she decided to have made pure D-mannose resourced from locally grown trees and used it on herself. Within a short time, the acute pain lessened and she gradually recovered, kidneys doing well much to the astonishment of the consultants. That was 9 nine years ago.
    The medication is sold in either powder or tablet form. How D-m works is so clever: e-coli has little barbs/hooks on it and it thrives on sweet things. D-mannose is very sweet. When the two meet the barbs detach from our organs and latch onto the D-m instead, like velcro, then get flushed away down the loo!
    It’s now used in countries worldwide…
    Well worth looking at! Best wishes, Pat

  • Monica

    I do not have fully functioning kidneys due to reflux when I was a child. It was fixed but the damage was done (scar tissue, small kidney, etc.). UTI’s have been constant in my life. I started a new infection in April and finally after my 4th one and multiple different antibiotics…was told that I have a strong strain (they referred to it as a “super bug”) of E Coli that is resistant to antibiotics. Yesterday they inserted a PIC line and now I have the antibiotic put directly into my system once a day for two weeks. I’m 49 and this is a first for me to not have the normal line-up of UTI antibiotics work. Worrisome? Yes. Just need to figure out how we go from here as this won’t be my last infection.

  • Anna

    I started having reoccurring uti’s maybes round December last year, it’s almost September now.. I’m getting frustrated and worried. I have consulted my doctor and she has tested me for vaginitis, chlamydia, ghonnorea (sp??) and a couple of other things and every thing came out ok. But I still keep having them and have to keep taking treatments. I don’t want anymore treatments! I want a preventative! I’m tired and frustrated and worried about my body and these infections. I know its normal but I feel weird and dirty. I’ve read a whole bunch of sites about wiping right and drinking water and cranberry juice and pills and do that… They keep coming back. I am sexually active but I know that uti’s can’t be passed and, like I said, I got checked out…. I’m done with this… HELP ME :,(

  • http://Haven't Hawaa

    Recurrent e coli infection for twenty years all types of antibiotics of no positive results now. Iended with cefotaxime sodium still infected . Help me please

  • Cindy

    A few years back I kept getting UTI’s and finally my husband was tested and he had an infection and kept passing it on to me. Your partner should be tested too. Hope this helps.

  • http://gerkasvan@fnail.com geraldine kasvan

    i am going crazy with these infections. i am diabetic with copd. i never feel well. my doctor says that i am a puzzle and this time put me on a drug that was taken off the market. he put me on ampecilin. for ten days.if this doesn*t work he will try me on low dose antibiotics for length of time. he will put me in the hospital for intravenous,

  • bazia

    Hello, I already suffer four years, and the doctor says it’s normal and all have e coli

  • Euni

    I got a UTi a week after having sex, even though I do remember peeing before and afterwards. I waited about a week or so before seeing a doctor, trying to cure it with water, cranberry juice, and AZO but nothing seemed to work. Then, I took a 1 week round of Nitrofurant, which is a substitution for Macrobid. My symptoms became worse. I went back to the doc to get a different round of antiobiotics, Cipro, and they also did a culture of my urine. This is my 2nd day of Cipro, and my symptoms are still pretty much the same. Nothing is more unbearable than a UTI, I hope everyone can find some relief to this awful infection.

  • Rebecca

    As a preventative, I would suggest not wearing thong underwear anymore. This could be the cause of most women’s uti’s. I stopped wearing them and my problem has gone away. Do whatever you can to lessen the chases of ecoli from your backside getting to your vagina.

  • painfulUrination

    I was diagnosed on Aug. 16 with a UTI and prescribed Bactrim for 7 days by a primary care doctor. By day five, I felt worse so I called the office. They never called back. I tried my luck with the folks in Patient First. She prescribed peridium and cipro. Began to bounce back until the day after my cipro ran out and then was pain again. The primary care doctor called back and said to see a gyn or uro doc. I saw a new woman uro who examined me and sent my urine to a lab. All negative. In the mean time, continued cramping, frequent urination. I called her office and she just repeated all negative. Give it time! None of this normal for me as I was 100 percent healthy before. Found a new doc, this time a nurse practictioner. She said my test strip was negative and that I should give it time due to my stress being the cause of all this. (What?) Anyways, they found two new strands of bacteria. Now I’m on Augmentin for 10 days and I have diarreha so I probably am going to reinfect myself with something totally new. God, when will they help me this time? Why are they so not helpful and quick to blame your emotions for the pain?

  • kaitlin

    This random doctor at the ER gave me Cipro for my E. coli urinary tract and kidney infection. But I’d read Cipro, and other flouroquinolones (some of which have been taken off the market), can cause all sorts of neurological side effects in people.

    So I went to my Naturopthic Doctor who gave me this anti microbial herbal tincture (Goldenseal), and a sugar called D-Mannose, which is found in cranberries. Research D-Mannose people, contrary to what the above article says about using cranberries as a treatment for E. coli infections, D-Mannose does work, and well.

    My infection cleared right up. The pain was gone in about twenty-four hours.

    It sucks we are overusing antibiotics, yes, especially in livestock. But we should not panic. There are alternative treatments, and there will continue to be more developed. :)

  • marjie

    I have anti-botic resistant e-coli urinary infection, been going on for years. I blame the fact doctors would only give me enough anti-ibotics for 3 days, it never got cured, and of course would re-occur. We farmed, ate my own chicken (no anti-biotics) same with our home raised beef, grew organic veggies. Cranberry juice is a crock, I’m on my 20th year of infections, I’m not a 90 year old lying in a hospital bed waiting to die.

  • nohemi

    I have been suffering with recurring UTI’s for the past 5 months now. I’m in the doctors office about twice a month because I get them every 2 weeks. Yesterday I was referred to another Urologist. She showed me a list of about 15 antibiotics normally used to treat UTI’s. Out of the 15, the E. coli bacteria I have is resistant to about 11 of them and only sensitive to 4. Her solution… put me on another antibiotic called Ceftin -_- like that is going to do much at this point. At this point I feel the more antibiotics they give me the more resistant its becoming. I’m tired of always having a UTI infection. My aunt suggested I try a home remedy where I pour some white vinegar in a bucket of steaming hot water and sit over the bucket to let the steam rise. I haven’t tried it yet but at this point what do I have to lose. I’ll let you guys know how it goes.

  • BeetleJes

    I went to the ER months ago, treated for a uti. Was still very sick a week later, went to a nurse practioner, she said that the ER gave me the wrong antibiotics, especially seeing as how I only have one kidney. Sent me home with a 10 day cycle of antibiotics. Completed those, got even more sick…began running 105 fever, was admitted to the hospital for four days with a severe kidney infection. Hooked up to saline and antibiotic drips the entire course of my stay. I get discharged with 10 day cycles of both Cipro and Bactrim…MORE antiobiotics even after strong IV antibiotics that I received. Not to mention the 10 day and 3 day cycles that I completed before being admitted. I’ve been on antibiotics for 3 months now. I wipe properly, drink plenty of water. Lemon water and also cranberry juice are my favorite fluids. I don’t use harsh soaps or detergents. I juice fresh fruit and vegitables every day. I’m still sick.


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