Pathogens often inhabit the body asymptomatically, emerging to cause disease in response to unknown triggers. In the bladder, latent intracellular Escherichia coli reservoirs are regarded as likely origins of recurrent urinary tract infection rUTI , a problem affecting millions of women worldwide.
However, clinically plausible triggers that activate these reservoirs are unknown. Several lines of evidence suggest that the urinary tract is routinely exposed to vaginal bacteria, including Gardnerella vaginalis , a dominant member of the vaginal microbiota in some women. Using a mouse model, we show that bladder exposure to G. Transient G. Millions of women suffer from recurrent urinary tract infections rUTI and the only treatment option is prophylactic antibiotics, which contributes to antibiotic resistance.
In experimental models, Escherichia coli , the dominant UTI pathogen, establishes reservoirs inside the bladder lining; it is believed that some cases of rUTI in women may be due to these reservoirs awakening in response to triggers that are still unknown.
Here we present a new mouse model that demonstrates the first clinically plausible trigger of rUTI arising from these reservoirs. Specifically, we show that bladder exposure to Gardnerella vaginalis , a common member of the vaginal microbial community, can drive the emergence of E.
Bladder exposure to G. Taken together, these data provide the first explanation for why certain characteristics of the vaginal microbiota have been linked with rUTI. Finally, our findings suggest that targeting specific members of the vaginal community may be an effective strategy for treating rUTI. PLoS Pathog 13 3 : e This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
