Research in Focus: A Novel Therapy For Urinary Tract Infections

As part of #BiofilmWeek, we’re highlighting interesting and exciting biofilm research being undertaken across our NBIC partner research institutions by early career researchers, PhD students and our Interdisciplinary Research Fellows.

We interviewed Ashraf Zarkan, a Research Fellow from the University of Cambridge. His research sits within the healthcare and pharmaceuticals sector and he is investigating an enzyme in Escherichia coli (E. coli) as a target to inhibit biofilms in urinary tract infections (UTIs).

How does your work link to biofilms and AMR?

UTIs are among the most common bacterial infections, affecting 150 million people per year worldwide and 75% of infections are due to uropathogenic E. coli. A major problem with UTIs is recurrence of infection associated with the ability of bacteria to form biofilms on the bladder lining or on indwelling catheters. There is an urgent need for innovative treatments to combat bacterial biofilms in UTIs. Furthermore, antibiotic resistance in UTIs is on the rise and UTIs are major drivers of antibiotic prescribing in primary care. Thus, my work has the potential for significant impact, not just for improving patient outcomes, but also for global antimicrobial stewardship.

What are the problems that work hopes to address?

An anti-biofilm treatment for UTIs is highly important. It would be useful for both complicated and uncomplicated UTIs, including cystitis (lower UTIs) and pyelonephritis (upper UTIs). It can be combined with antibiotics to enhance treatment outcome, but its most useful application is prophylactically to prevent recurrency, complications and progression of cystitis into pyelonephritis. Importantly, E. coli biofilms play a significant role in the development of UTIs into E. coli bacteraemias with potential severe complications and high number of deaths. In fact, E. coli is the main cause of bacteraemias in the UK and US with around 20% of cases resulting in death, and the majority of E. coli bacteraemias are from a UTI origin. Furthermore, UTIs are huge burden to healthcare providers. In the UK, UTI treatment takes up a large proportion of resources within the NHS, and the annual cost of UTI management in England alone is over £100m. Thus, anti-biofilm treatment for UTIs will have a significant indirect value by releasing resources in the healthcare system, in addition to the direct value with patients suffering UTIs.

Are there any highlights from your work you can tell us about?

Following an extensive screening and testing of potential inhibitors of E. coli biofilms, we have now identified few top candidates and confirmed their ability to inhibit biofilm formation in a collection of uropathogenic strains of E. coli. We are currently optimising these candidates and preparing for preclinical testing using a UTI mouse model. We are also exploring the potential of embedding some of our inhibitors into coatings of urinary catheters to generate catheters with antibiofilm properties. The planned work will start with proof-of-concept testing using a urinary catheter model.