Urinary tract infection prophylaxis using Escherichia coli 83972 in spinalcord injured patients

Purpose: Escherichia coli 83972 was previously shown to establish bladder c olonization in select patient groups. We evaluate the safety and feasibilit y of using bacterial interference with E. coli 83972 to prevent urinary tra ct infection in spinal cord injured patients. Materials and Methods: A total of 21 men and women with neurogenic bladder secondary to spinal cord injury underwent intravesical inoculation with E. coli 83972. Frequency of symptomatic urinary tract infection before and aft er colonization was compared. Results: Successful long-term bladder colonization was achieved in 13 study participants. Mean duration of colonization was 12.3 months (range 2 to 40 ). Subjects had no symptoms of urinary tract infection while colonized with E, coli 83972 (0 infection per 18.4 patient-years). Successfully colonized subjects had experienced a mean of 3.1 symptomatic urinary tract infection s per year (range 2 to 7) before colonization. Symptomatic infection also o ccurred in 4 subjects who were not successfully colonized with E, coli 8397 2 and in 7 others after spontaneous loss of colonization. Colonized subject s reported subjective improvement in quality of life with respect to urinar y tract infection while colonized. Conclusions: E. coli 83972 may be safely used to establish long-term asympt omatic bladder colonization in spinal cord injured subjects. Preliminary fi ndings suggest that colonization with E. coli 83972 may reduce the frequenc y of urinary tract infection in patients with neurogenic bladder secondary to spinal cord injury.