The New York Times/Matt Richtel: Urinary Tract Infections Affect Millions. The Cures Are Faltering.

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Deadly germs, lost cures

Urinary Tract Infections Affect Millions. The Cures Are Faltering.

As the infections become increasingly resistant to antibiotics, some standard treatments no longer work for an ailment that was once easily cured.

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Dr. Lee Riley of the University of California, Berkeley, has been studying antibiotic-resistant strains of E. coli, which can cause urinary tract infections. “We’ve suspected maybe some of these U.T.I. cases may be food-borne,” he said.CreditCreditBrian L. Frank for The New York Times

By Matt Richtel

• July 13, 2019
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For generations, urinary tract infections, one of the world’s most common ailments, have been easily and quickly cured with a simple course of antibiotics.

But there is growing evidence that the infections, which afflict millions of Americans a year, mostly women, are increasingly resistant to these medicines, turning a once-routine diagnosis into one that is leading to more hospitalizations, graver illnesses and prolonged discomfort from the excruciating burning sensation that the infection brings.

The New York City Department of Health has become so concerned about drug-resistant U.T.I.s, as they are widely known, that it introduced a new mobile phone app this month that gives doctors and nurses access to a list of strains of urinary tract infections and which drugs they are resistant to.

The department’s research found that a third of uncomplicated urinary tract infections caused by E. coli — the most common type now — were resistant to Bactrim, one of the most widely used drugs, and at least one fifth of them were resistant to five other common treatments.

“This is crazy. This is shocking,” said Lance Price, director of the Antibiotic Resistance Action Center at George Washington University, who was not involved in the research.

The drug ampicillin, once a mainstay for treating the infections, has been abandoned as a gold standard because multiple strains of U.T.I.s are resistant to it. Some urinary tract infections now require treatment with heavy-duty intravenous antibiotics. Researchers last year reported in a study that a third of all U.T.I.s in Britain are resistant to “key antibiotics.”

Certainly, the day-to-day experience of having a U.T.I. is growing less routine for many women.

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Carolina Barcelos, 38, a postdoctoral researcher in Berkeley, Calif., said she had several U.T.I.s as a teenager, all successfully treated with Bactrim. When she got one in February, her doctor also prescribed Bactrim, but this time it didn’t work.

Four days later, she returned and got a new prescription, for a drug called nitrofurantoin. It didn’t work either. Her pain worsened, and several days later, there was blood in her urine.

Her doctor prescribed a third drug, ciproflaxacin, the last of the three major front-line medicines, and cultured her urine. The culture showed her infection was susceptible to the new drug, but not the other two.

“Next time,” Dr. Barcelos said, “I’m going to ask them to do a culture right away. For eight days I was taking antibiotics that weren’t working for me.”

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