| Summary: | An extensive clinical, microbiological and biochemical study was carried out in patients with intestinal segments transposed into the urinary tract. Three main questions were addressed in the present work. What is the cause of persistence or recurrence of urinary tract infection in this cohort of patients? Within the urinary tract, mucosal cells or urinary mucus plugs could form two potential sources of recurrences of infections in these patients. The preliminary electron microscopic observation suggested that mucus plugs contained multiple colonies of various bacterial strains. This work was supported by a subsequent molecular analysis of cultured isolates from mucus plugs and urine, which showed at least one bacterial isolate to be common between mucus plugs and urine. Is it possible to predict recurrent urinary tract infections in these patients? An assessment of the urinary proteome in this cohort of patients was carried out, specifically to find out any differences in the proteins profile of patients with or without urinary tract infections. Urinary proteins were isolated and resolved by two dimensional gel electrophoresis (2-DE). The 2-DE profiles obtained in patients were compared with normal healthy volunteers. The identified proteins included pancreatitis-associated protein 1, human lithostathine alpha 1 precursor, liver fatty acid binding protein and testis expressed protein 12. One of these proteins (pancreatitis associated protein 1) was validated using ELISA technique. What is the effect of cranberry juice intake on the symptomatic recurrence of infections in these patients? In order to answer this question, we assessed the effect of cranberry juice intake on recurrent symptomatic urinary tract infections, bacteriuria, pyuria and quality of life of patients with urinary bladder replaced or reconstructed using intestinal segments in a randomized placebo-controlled cross over trial. The trial showed no significant impact of cranberry intake on recurrent symptomatic urinary tract infections, however, there was a significant improvement in patients reported quality of life.
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