Effect of human urinary microenvironment and fluid flow on antibiotic and phage therapy efficacy against uropathogenic Escherichia coli.

Microenvironmental factors in the human urinary system significantly reduce the effectiveness of antibiotics and phages against uropathogenic Escherichia coli, especially under flow conditions.

• Why it matters: Understanding how the urinary microenvironment impacts treatment responses is crucial because conventional assays often fail to predict clinical outcomes, hindering effective management of recurrent UTIs amid rising resistance.
• What they did: Researchers used a human urothelial microtissue model and a novel fluid flow platform to study UPEC responses to antibiotics and bacteriophages, examining bacterial behavior and therapy efficacy under static and flow conditions.
• The result: Flow conditions promoted bacterial growth and reduced therapy effectiveness despite increased drug exposure, highlighting the importance of physiologically relevant models to optimize treatment strategies against resistant UTIs.