DORMANT MICROBES IN INTERSTITIAL CYSTITIS

Interstitial cystitis (IC) is an inflammatory disease of the urinary b ladder that has no known etiology. A microbial association with this d isease has not been supported since routine cultures of urine from IC patients are usually negative. However, we have demonstrated the prese nce of bacterial 16S rRNA genes in bladder biopsies from 29% of patien ts with IC, but not from control patients with other urological diseas es. The ability to identify the presence of bacterial DNA in these pat ients was accomplished using a sensitive and specific nested PCR metho d capable of amplifying 16S rRNA genes from a wide variety of bacteria l genera. Cloning and sequencing of 16S rRNA gene fragments amplified from bladder tissue of IC patients showed that these genes were derive d from genera representing Gram-negative bacteria. In addition to the molecular data, a novel finding of 0.22 mu m. filterable forms has bee n isolated in culture from the biopsy tissue of 14 of 14 IC patients a nd from 1 of 15 controls. The forms contain nucleic acids and resemble cell wall-deficient bacteria in gross morphology; however, their swir led myelin-like ultrastructure is unusual and suggests a heretofore un classified microbe. These results demonstrate for the first time an as sociation of Gram-negative bacterial DNA and filterable forms with aff ected bladder tissue from patients with IC.