Why are recurrent UTI’s so recurrent? All about biofilms.

Have you ever felt that lingering UTI tingle that feels never ending? Been on the merry go round of antibiotic treatment with continual frustration and discomfort? As a Clinical Naturopath with a special interest in vaginal and urinary health, I know exactly how you feel. Many of my clients experience similar symptoms, however, the one consideration that is generally missed with recurrent UTIs… biofilms. Addressing biofilms may be the answer you are looking for.

What is a "Recurrent UTI"?

A recurrent UTI is generally defined by two or more culture-proven infections within a 6 month period, or three or more in a 1 year period. They are debilitating, and frustrating. But most of all, the bacteria in UTIs are SMART.

What is a "Biofilm"?

Bacterial biofilms are closed bacterial communities in which the bacteria are embedded in an strong material matrix created by the bacteria itself. This anchors the bacterial colony at the infection site and provides a protective shield against host defences, as well as antimicrobial (and antibiotic) treatments. The bacterial population within the biofilm rearrange their priorities in order to create their “attack plan”, where bodily activities are reduced in order to conserve energy and nutrients. At the same time, toxins are upregulated in order to encourage maximum possible tissue damage; this ensures generous release of nutrients at the infection site and further cements the biofilm in site.

Why is it so important with UTIs?

Antibiotic resistance may be significantly higher in urinary bacteria’s within biofilms, up to 1000 times higher than in free-floating bacteria. There are several pathways in which biofilms impact the urinary microbiome and their bacteria’s:

1. Antibiotics cannot be used to their ultimate ability due to the protective action of the biofilm, causing reduced effectiveness. This is ultimately called antibiotic resistance.

2. Bacteria within biofilms exhibit act as “bounders”, meaning they essentially pump out harmful toxins or antibiotics out of the biofilm environment, reducing the ability for damage to occur.

3. The close cell-to-cell contact within biofilms allows the bacteria to share information among each other, therefore they can become antibiotic resistant faster.

How can naturopathic medicine help reduce recurrent UTIs through breaking down biofilms?

Naturopaths use a holistic approach that understands the drivers of biofilms, but also using mechanisms that are different to antibiotics. We can work alongside modern medicine to reduce the use of antibiotics (which are 100% necessary in many cases of UTIs to avoid kidney damage). There are a variety of “biofilm busters” available, that can be used specifically depending to the individual, their needs, and the bacteria that are present for them.

As a Clinical Naturopath with a special interest in vaginal and urinary health, I am here to guide and support you while using personalised medicine. Not one size fits all, especially with something as intricate as the urinary microbiome.

Interested in a consult? Book in a FREE Discovery call today to see how I can help you.

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References:

1. Ejrnæs, K., Stegger, M., Reisner, A., Ferry, S., Monsen, T., Holm, S. E., Lundgren, B., & Frimodt-Møller, N. (2011). Characteristics of Escherichia coli causing persistence or relapse of urinary tract infections: Phylogenetic groups, virulence factors and biofilm formation. Virulence, 2(6), 528–537. https://doi.org/10.4161/viru.2.6.18189

2. Lila, A. S. A., Rajab, A. A. H., Abdallah, M. H., Rizvi, S. M. D., Moin, A., Khafagy, E.-S., Tabrez, S., & Hegazy, W. A. H. (2023). Biofilm Lifestyle in Recurrent Urinary Tract Infections. Life, 13(1), 148. https://doi.org/10.3390/life13010148

3. Mancuso, G., Trinchera, M., Midiri, A., Zummo, S., Vitale, G., & Biondo, C. (2024). Novel Antimicrobial Approaches to Combat Bacterial Biofilms Associated with Urinary Tract Infections. Antibiotics, 13(2), 154. https://doi.org/10.3390/antibiotics13020154

4. Soto, S. M., Smithson, A., Horcajada, J. P., Martinez, J. A., Mensa, J. P., & Vila, J. (2006). Implication of biofilm formation in the persistence of urinary tract infection caused by uropathogenic Escherichia coli. Clinical Microbiology and Infection, 12(10), 1034–1036. https://doi.org/10.1111/j.1469-0691.2006.01543.x