Wanda Reygaert 1* and Ilir Jusufi2 1 Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine,

Rochester, MI, USA 2 Biomedical Diagnostic and Therapeutic Sciences Program, Oakland University School of Health Sciences,

Urinary tract infections (UTIs) are the second most common

type of infection found in any organ system, and the most

common type of nosocomial infection

These UTIs are responsible for over eight million doctors

visits per year in the US and result in medical costs of over six

billion dollars worldwide per year

Most UTIs (80–90%) are the result of infections with

Escherichia coli

Non-pathogenic strains of E. coli are an important part of the

normal flora in the intestinal tract.

The strains of E. coli that infect the urinary tract are

categorized as uropathogenic E. coli

The UPEC are able to produce special surface proteins

(adhesins) that allow them to attach to and invade the

epithelial cells that line the urinary bladder

If the infection is not eradicated while it is in the bladder ,

some strains of UPEC may then travel up the ureter to the

kidneys and cause even more severe infections (complicated

UTIs), which can lead to renal damage and possibly renal

failure

There are 14 serogroups of UPEC that are most commonly

found in UTIs, and 75% of UTIs have been shown to be caused

by serogroups 04, 06, 014, 022, 075, and 083

The most common serogroups involved in causing UTIs

worldwide are 02, 04, 06, and 075

In the U.S., 49% of UTIs in women have been found to be

caused by serogroups 06, 04, and 075, in descending

frequency of occurrence

The antimicrobial agents that have traditionally been used to

treat UTIs (β-lactams, fluoroquinolones, trimethoprim–

sulfamethoxazole, nitrofurantoin, etc.) are becoming less

effective

In recent years, the number of antimicrobial resistant strains

of E. coli isolated from UTIs has been increasing, including

resistance to antimicrobial agents normally used to treat UTI.

A urinary tract infection (UTI) is an infection involving the

kidneys, ureters, bladder, or urethra. These are the structures

that urine passes through before being eliminated from the

body.

The upper urinary tract is composed of the kidneys and

ureters. Infection in the upper urinary tract generally affects

the kidneys (pyelonephritis), which can

cause fever, chills, nausea, vomiting, and other severe

symptoms.

The lower urinary tract consists of the bladder and the

urethra. Infection in the lower urinary tract can affect the

urethra (urethritis) or the bladder (cystitis).

Urinary tract infections are much more common in adults

than in children, but about 1%-2% of children do get urinary

tract infections.Urinary tract infections in children are more

likely to be serious than those in adults and should not be

ignored (especially in younger children).

These infections are much more common in girls and

women than in boys and men younger than 50 years of

age. The reason for this is not well understood, but

anatomic differences between the genders (a shorter

urethra in women) might be partially responsible.

About 40% of women and 12% of men have a urinary

tract infection at some time in their life.

Green tea is derived from non-fermented leaves of the

Camellia sinensis plant. Oolongand black tea are made from

fermented leave from the same plant. Green tea has been a

falvoured drink, traditionally, in Asian countries. Because of

studies that have shown the potential health benefits of green

tea, it is now gaining worldwide popularity as a drink that is

important in preventative medicine. Studies using green tea

have show init to have potential benefits, most notably in :

cardiovascular disease, cancer, diabetes ,obesity, oral health,

bone health ,and cognitive function.

Catechins

(Astringency component in tea)

Decreases blood cholesterol

Body fat reduction

Cancer prevention effect

Antioxidant

Tooth decay prevention, antibacterial effect

Anti-influenza effect

Inhibits high blood pressure

Anti-hyperglycemic effect

Bad breath

Vitamin E

Antioxidant

β-carotene

Maintenance of nightime vision

Fluorine

Prevention of tooth decay

(

Minerals

(Potassium, calcium, phosphorus,

manganese, etc.)

Biological regulators

Chlorophyll

Deodorizing effect

Catechins

Catechins are a type of polyphenol and are the main astringency component

in green tea, long known as tannins. Catechin was first isolated from the

Indian plant extract catechu (from the plant acacia catechu, a tree of the

fabaceae family, acacia genus), from which it derives its name. Tea catechin

was first isolated by Dr. Michiyo Tsujimura in 1929 at RIKEN (The Institute of

Physical and Chemical Research) in Japan. There are four main types of

catechins found in tea leaves.

Epicatechin

Epigallocatechin

Epicatechin gallate

Epigallocatechin gallate

Three of these catechins, ECG, EGC, and EGCG have been show

to have antimicrobial effects against a wide variety of

microorganisms

The two found in the highest amounts in green tea are EGC and

EGCG. Both of these are excreted in bile, but EGC is also

excreted in the urine, suggesting the possibility for green tea

having antimicrobial activity in UTI

The aim of the current study was to investigate the

susceptibility of UPEC strains, representing a wide variety of

antimicrobial susceptibility patterns, to green tea.

1: The bacterial strains used for this study were part of a

research collection of E.coli

Isolated from UTI cultures during the year 2007-2008.

2: 80 isolates were selected from this collection that

represented a wide spectrum of antimicrobial susceptibility

pattern.

3: two control strains that were susceptible to all the clinically

tested antimicrobials were selected.

1: A standardized green tea (C.sinensis) extract (standardized to 7.0%

polyphenols) was obtained from Swanson Vitamins®.

2: HOW TO EXTRACT??

Strong infusions:

a) Green tea leaves are processed by soaking in the aqueous solution of

alcohol

b) Purified extracts: Further purification is done by chromatography or

solvent extraction

3: The plant extract was prepared in water.

SWANSON VITAMINS®:They produce health products.

1: The media used in this experiment is LA (Luria-Bertani)

2: Dehydrated Muller –Hinton agar (MH media)

Muller- Hinton agar is used in Antimicrobial susceptibility test.

E.coli strain O157:H7 can cause severe problems in the intestine and urinary track

It produces a toxin that in the intestine and damages the wall of the intestine.

TWO TYPES OF UTI’s. 1: Cystitis(infection of the bladder): by the E.coli

found in the gastrointestinal track. 2: Urethritis(infection of the urethra):when the

gastrointestinal E.coli spreads from anus to the urethra.

CAUSES: Sexual contact, contaminated water or food. COMPLICATIONS: Permanent kidney damage.(chronic

kidney infection)

PROCEDURE:1: The minimum inhibitory concentration of the green tea extract was determined by agar dilution method.

2: The MHA plates contain various concentration of green tea extract(0,2.5,3.0 and 4.0 mg/ml)

3: Suspensions of 0.5 McFarland standard dilutions were prepared from bacterial culture grown overnight in LB broth.

4: A 10-4 dilution of these suspensions was prepared and 100µl of dilution of dilution per plate was inoculated using spread plate technique.

5: The plated concentration equals 1.5×10-3.was incubated at 37˚C for 48hours , and on the basis of colony counts, the MIC was determined as the lowest concentration of green tea extract to show an inhibitory effect on growth of bacteria (no colonies detected).Each strain was tested three times.

MIC DETERMINATION:

The MIC and susceptibility results were as follows:

1: 99% were susceptible to green tea extract at a concentration

of ≤4.0mg/ml.(one strain was not suscetible at even 4.0mg/ml)

2: 94% were susceptible at ≤3.5mg/ml.

3: 76% was susceptible at ≤3.0mg/ml.

4: 40% was susceptible at ≤2.5mg/ml

5: The control strain varied; one being susceptible at

≤2.5mg/ml and the other susceptible at ≤3.5mg/ml

COMPONENT Number of isolates tested(% out of 79)

32(40%) 29(37%) 14(18%) 4(5%)

Total GTE (mg/ml) < 2.5 <3.0 <3.5 < 4.0 or or or or

= 2.5 =3.0 =3.5 =4.0

EGC (microgram/ml) < 450 <540 < 630 < 720 or or or or

= 450 = 540 = 630 = 720

1: This study shows that green can have an antimicrobial effect on E.coli bacteria that causes UTI’s.

2: This research data also adds to the current information on the potential health benefits of green tea.

-traditionally used to control bleeding and heal wounds, aid digestion , improve heart and mental health in India and China.