URODYNAMIC FACTORS INFLUENCE THE DURATION OF ESCHERICHIA-COLI BACTERIURIA IN DELIBERATELY COLONIZED CASES

Purpose: We evaluated the influence of urodynamic factors on the estab lishment of bacteriuria, after deliberate intravesical inoculation wit h Escherichia coli, Materials and Methods: Nine women and 7 men with r ecurrent symptomatic urinary tract infections underwent intravesical i njection of E. coli 83972, This strain had documented ability to persi st in the urinary tract and it lacks expressed virulence factors assoc iated with urinary tract infection. Results: Successful long-term colo nization (5 months to 3 years) was achieved in 6 of 12 patients with n eurogenic bladder disorder, including normal or high bladder capacity, normal or low detrusor pressure and residual urine. Short-term bacter iuria (13 days) occurred in 1 but long-term bacteriuria was not establ ished in the 4 patients with normal lower urinary tract function. Occa sionally urine samples from the colonized patients contained other bac terial strains, which cleared spontaneously except for a Klebsiella st rain that became established in 2 and subsequently eliminated E, coli 83972, Conclusions: E. coli 83972 bacteriuria could only be establishe d in a subset of patients with defective bladder voiding, suggesting t hat urodynamic defects permit a nonvirulent strain to establish in the urinary tract, but that additional host factors determine if bacteriu ria will persist.