Chronic UTI and Pain: Why Don’t We Have a Vaccine Yet?

Why doesn’t UTI, an infection so widespread, having such serious consequences, not have a vaccine yet? We decode.

Urinary tract infections (UTIs) are among the most common bacterial infections found in humans, affecting more than 150 million people worldwide.

(Photo: iStockphoto)  

Urinary tract infections (UTIs) are among the most common bacterial infections found in humans, affecting more than 150 million people worldwide. Data shows that about 12 percent of men and about 40 percent of women experience at least one symptom of UTI during their lifetime while 40 percent of women who are infected may show recurring symptoms.

Pregnant and menopausal women are also at a higher risk of the infection owing to the multiple hormonal and physiological changes that happen in their bodies. In men, an enlarged prostrate gland or restrictive flow of urine might put them at risk of an infection.

Long term UTI may prompt the spread of the bacteria to the kidneys, especially in pregnant women and diabetics, resulting in complete renal failure.

So, an infection so widespread, having such serious consequences must have a vaccine, right? Wrong.

Let’s understand why there’s still no vaccine for UTI.

What Exactly is UTI?

A urinary tract infection (UTI) is an infection caused by bacteria in any part of the urinary system.(Photo: iStockphoto)  

A urinary tract infection is an infection caused by bacteria in any part of the urinary system (comprising kidneys, ureters, urinary bladder and urethra). It develops when the bacteria begins to multiply in the urinary bladder after entering the urinary tract. In cases, when the urinary system isn’t able to destroy this bacteria, it spreads and develops into an infection.

So naturally most of the cases get detected in a urine test and are often thought to be short-lived. Doctors often recommend a course of antibiotics for young patients.

Speaking to FIT previously, Dr N Subramanian, Senior Consultant – Urology, Indraprastha Apollo Hospital, Delhi, had explained:

Young women are usually put on antibiotics for 3-4 days, post which the symptoms reduce considerably. For older patients, the treatment might vary a little. Post the initial round of antibiotics, they will need to be monitored further.

But for thousands of women, who experience recurring symptoms and whose condition turns chronic, short-term antibiotic courses don’t help. Why?

Why Antibiotics May Not Be The Answer?

Overuse of antibiotics can cause the bacteria to become resistant over time.(Photo: iStockphoto)

Maybe the reason lies in the fact that experts are unable to detect exactly which microbe is causing the infection or whether is it a group of microbes. Though E.coli is known to cause 80 percent of all UTIs, there’s still a lack of research in this field.

As per a report in The Guardian, Professor Malone-Lee and his team in London have been conducting tests which could help understand why recurring UTIs are difficult to treat.

When Professor Lee’s team grew a set of bacterial species along with some bladder cells, they found that the bacteria had a way to escape treatment. They would form ‘nests’ on the interior of the bladder wall and get into hibernation mode for months on end which would help them evade the antibiotics.

The team thinks this is the reason why the infection reoccurs in some women and why short-term treatments may be ineffective. Since the bladder wall regenerates in about every nine months, the patients must be treated for at least this long to get rid of the infection completely.

But his approach also raises serious issues about antibiotic resistance. Overuse of antibiotics can cause the bacteria to become resistant over time, giving rise to more issues not only for the patients but also for the environment and public health.

Isn’t there an alternative?

Slow Research on Alternative Methods

The development of a UTI vaccine caught the attention of the medical community in the 1950s and ever since then, a variety of studies have been undertaken.(Photo: iStockphoto)

A 2018 report in Verywell Health, stated that in July 2017 Food and Drug Administration (FDA) had granted Sequoia Sciences’ FimCH UTI vaccine a ‘fast track designation’ (to accelerate the review of drugs to treat serious conditions). This means that once approved, this vaccine could become the first vaccine for UTI in the United States.

But there hasn’t been an update on this since.

An earlier study published in 2016 in the journal Nature, had shed light on the same possibility of using an oral, non-antibiotic drug that could help attack the protein, FimH, that helps bacteria like E.coli to stick to the interior of one’s bladder, resulting in an infection.

Another study published in the journal PLOS in 2015, found that an ‘immune boosting agent’ could act as a natural defense against UTI.

While these studies did show promise, it’s discouraging to note that the trials seem to have been dropped along the way, without a concrete solution.

So is there no hope for a UTI vaccine?

Of Pharma Companies, Medical Trials and Women's Bodies

Women who are patients of chronic UTI have often been told by a doctor, that the pain is in their head.(Photo: iStockphoto)

The development of a UTI vaccine caught the attention of the medical community in the 1950s and ever since, a variety of studies have been undertaken.

We are now in 2019, 60 years later, and still waiting for some light on the vaccine. One might wonder whether the intention still persists to develop a vaccine.

Researchers who have been in this field, argue that the fact that antibiotics are often prescribed for a longer duration to the patients of UTI, invariably translates to more money for the pharmaceutical companies which may not be able to reap the same profits if a single drug could treat the infection. So even if researchers did pursue trials for a vaccine, they would face a resistance from the bigger players.

And the constant mocking of women who suffer from chronic pain just makes the entire situation worse.

Women who are patients of chronic UTI have often been told by doctors, that the pain is in their head and that maybe they need to consult a psychiatrist or psychologist.

So, if you are suffering from UTI, chances are you will still be forced to pop antibiotics until a miracle makes the FDA approve the new drug.