Urinary Tract Infections: Statistics and Facts

Urinary tract infections (UTIs) are the most common bacterial infection in the world, accounting for nearly 25% of all infections in women, and resulting in 250 million infections annually. Almost half of all women with a UTI will experience recurrent infections requiring additional antibiotic treatment. One out of three women will have to get antibiotic treatment for UTIs by the age of 24. 

Because of antibiotic overuse in medicine (over 30% of antibiotics prescribed in the USA are unnecessary) and livestock, there is a growing prevalence of resistant UTIs that are not susceptible to last-line antibiotic treatments. As a result, leading doctors and researchers have put increasing emphasis on the need for UTI prevention as the primary method for managing recurrent UTIs.

It is no longer acceptable to wait for UTIs to happen and treat them with antibiotics, because the antibiotics may not work. When taken daily, Dmanna's key ingredient, d-mannose, has been proven to decrease antibiotic usage by preventing UTIs before they happen. Women who took Dmanna's core ingredient every day experienced 4x fewer UTIs than women taking daily antibiotics. 

On this page, you'll find links to studies helping to advance the discovery and development of UTI prevention methods and products like Dmanna, in addition to compelling facts and statistics that highlight the urgent need to continue research and innovation in this area.

 

Table Of Contents

1. D-mannose As A Scientifically Proven And Effective Daily UTI Prevention Treatment

2. Additional Reading and Research on Mannosides for UTI Prevention

3. Impact Of UTIs In Women And Affected Populations

 

1. D-mannose As A Scientifically Proven And Effective
Daily UTI Prevention Treatment

D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial.

  • World Journal of Urology; February 2014, Volume 32, Issue 1, pp 79–84.
  • "In this study, d-mannose powder was shown to significantly reduce the risk of recurrent UTI in the female subject."

D-mannose: a promising support for acute urinary tract infections in women. A pilot study

  • Eur Rev Med Pharmacol Sci 2016; 20 (13): 2920-2925.
  • "The results of this study suggest that D-mannose can be an effective aid in acute cystitis management and also a successful prophylactic agent in a selected population."

Oral D-mannose in recurrent urinary tract infections in women: a pilot study

  • Journal of Clinical Urology 2014 Volume: 7 issue: 3, page(s): 208-213.
  • "Mean time to UTI recurrence was 52.7 days with antibiotic treatment, and 200 days with oral D-mannose (p < 0.0001)." Women in the daily d-mannose powder group experienced significantly fewer UTIs in the same time period.
  • Conclusions: Bladder pain, Urinary urgency, and average numbers of 24-hour voidings decreased significantly.
  • "D-mannose appeared to be a safe and effective treatment for recurrent UTIs in adult women. A significant difference was observed in the proportion of women remaining infection free versus antibiotic treatment."

WebMD User Reviews of D-mannose for UTI Prevention

  • WebMD.com User Reviews & Ratings 
  • "It's so sad MDs don't know a thing about this product. Reliance on antibiotics is all that's prescribed. Cranberry juice is too acidic and counter productive, even in concentrate form without sugar."
  • "My daughter was born with Spina Bifida and has UTI's a lot. I used this and the results were amazing. The Urine cleared up and the other side effects went away. Now we will use this also to maintain good health."
  • "Have had three bladder augmentation surgeries and as a male, have suffered from continual UTI's. The drugs, in the short term worked, but actually made the condition worse and created candida. My physician (Functional) suggested this supplement and the effects are astounding. My urine no longer burns and my flow are increased and easier. When I don't take it I truly notice the difference."

Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats

  • Urological Research April 1983, Volume 11, Issue 2, pp 97–102
  • "The effect of D-mannose and D-glucose on bacteriuria due to Escherichia coli with mannose-sensitive adhesins was investigated in adult male Sprague-Dawley rats undergoing diuresis."
  • The results indicate that D-mannose can significantly reduce bacteriuria within 1 day.

 

2. Additional Reading and Research on Mannosides for UTI Prevention

Intervening with Urinary Tract Infections Using Anti-Adhesives Based on the Crystal Structure of the FimH–Oligomannose-3 Complex

  • PLoS One. 2008; 3(4): e2040.
  • Effectiveness of d-mannose as an e. coli bacteria inhibitor demonstrated: "We demonstrate that α-d-mannose based inhibitors of FimH not only block bacterial adhesion on uroepithelial cells but also antagonize invasion and biofilm formation. Heptyl α-d-mannose prevents binding of type 1-piliated E. coli to the human bladder cell line 5637 and reduces both adhesion and invasion of the UTI89 cystitis isolate instilled in mouse bladder via catheterization. Heptyl α-d-mannose also specifically inhibited biofilm formation at micromolar concentrations."
  • "Adhesion could be completely inhibited by the addition of 100 mM Man (regular d-mannose) to the bacterial inoculum, or by a 100-fold lower concentration of HM. No inhibition was obtained with 100 µM Man, whereas 1 µM of HM (HM=Heptyl d-mannose) still had some inhibitory effect. Similar data have been obtained with an inoculum of 107 cfu/ml. These results suggest that HM is more efficient at reducing FimH-mediated bacterial adherence, in accordance with its higher affinity for FimH."

Structure-based discovery of glycomimetic FmlH ligands as inhibitors of bacterial adhesion during urinary tract infection

  • PNAS March 5, 2018. 201720140
  • "Treatment with these FmlH antagonists [mannosides] significantly reduced bacterial burdens in the kidneys and bladders of infected mice, thereby demonstrating promising translational value in the treatment of UTI in humans. The results of these studies, together with our previous work on FimH mannosides, further support the mechanistic and therapeutic value of antivirulence strategies that leverage structure-function relationships of diverse bacterial adhesins for the rational design of high-affinity glycosides for the treatment of UTI and other bacterial infections."

Host-Pathogen Checkpoints and Population Bottlenecks in Persistent and Intracellular Uropathogenic E. coli Bladder Infection

  • FEMS Microbiology Reviews, Volume 36, Issue 3, 1 May 2012, Pages 616–648.
  • "Mannosides prevent acute cystitis caused by divergent and antibiotic-resistant strains: In addition to treating an established UTI, we have also shown that our lead mannoside compound has a potent efficacy in preventing acute UTI caused by divergent strains, including the TMP-SMZ resistant strain PBC-1."
  • "In this study, bladder titers in C3H/HeN mice were reduced approximately 100-fold at 6 hpi and the intracellular niche was eliminated, as UPEC were unable to invade the urothelium and form IBCs. The lead mannoside compound also acted synergistically with TMP-SMZ, which concentrates in the urine. This synergy appears to be a result of preventing UPEC invasion of urothelial cells and compartmentalization of UPEC to the bladder lumen, thus exposing bacteria to TMP-SMZ concentrations well above the minimal inhibitory concentration (MIC) of even a clinically resistant strain, resulting in bacterial cell death (TMP reached 9 mg mL−1 in the urine, well above the 256 μg mL−1 MIC of the resistant strain, PBC-1). It is likely that during current standard treatment, TMP-SMZ reaches tissue concentrations above the MIC needed for killing of sensitive strains but fails to reach tissue levels needed for killing PBC-1. Thus, in the absence of mannoside, residence of PBC-1 in an intracellular niche, such as in IBCs during acute infection, likely protects it from antibiotic killing. Currently, treatment of UTI typically requires a 3–10 day course of antibiotics or, in the case of chronic, recurrent cystitis, daily prophylaxis. Thus, our mannoside compounds have the potential to shorten this course and/or increase the efficacy of TMP-SMZ resulting in fewer treatment failures, if clinically translatable. Translated to clinical practice, mannosides could be a cost-effective treatment that lowers the clinical antibiotic resistance rate, which is currently as high as 30% in some studies (van der Starre et al., ) and may also reduce the use of fluoroquinolones, thus decreasing resistance. In addition, the unique mechanism of mannoside action, that is, inhibiting the function of the extracellular FimH pilus tip adhesin, negates the need for the compound to cross the bacterial outer membrane for efficacy, which thus would circumvent the development of resistance because of porin mutations or efflux."
  • "Conclusion: We hypothesize that an acute host–pathogen checkpoint exists early in acute infection that determines disease outcome. In this model, an initial severe and chronic infection with a highly virulent UPEC strain has the potential to sensitize individuals to recurrent infection, such that much less virulent UPEC strains are now capable of causing symptomatic rUTI. Such a model could explain, in part, the large degree of heterogeneity among UPEC isolates. Understanding the molecular mechanisms of this putative checkpoint will be critical for developing new therapeutic strategies to prevent rUTI. Likewise, we hypothesize that UPEC population bottlenecks not only offer an opportunity for therapeutic intervention, such as with the mannoside compounds, but also help us to understand bacterial survival strategies and host defense mechanisms that are in play during acute infection and chronic persistence."

Mannosides Fight Urinary Infections

  • Chemical & Engineering News ISSN 0009-2347
  • "Mannosides can treat and prevent urinary tract infections (UTIs), without inducing antibiotic resistance. The mannosides block the bacterial cell-surface receptor FimH, which bacteria use to interact with bladder epithelial cells to cause infection. In mice with chronic UTIs, the mannosides eliminated uropathogenic bacteria more effectively than did standard antibiotic treatments. The mannosides also work effectively with traditional antibiotics, and healthy mice treated with them don’t get infections. Bacteria typically develop resistance by pumping drug molecules out of their cells and mutating target proteins. But the mannosides function extracellularly, and mutating FimH could eliminate bacterial infectivity, making the development of resistance less likely than with standard antibiotics."

Treatment and Prevention of Urinary Tract Infection with Orally Active FimH Inhibitors

  • Science Translational Medicine  16 Nov 2011: Vol. 3, Issue 109, pp. 109ra115
  • "[Mannosides] have therapeutic efficacy after oral administration for the treatment of established urinary tract infections in vivo. Their unique mechanism of action—targeting the pilus tip adhesin FimH—circumvents the conventional requirement for drug penetration of the outer membrane, minimizing the potential for the development of resistance. The small–molecular weight compounds described herein promise to provide substantial benefit to women suffering from chronic and recurrent urinary tract infections."

3. Impact Of UTI In Women And Affected Populations

Urinary tract infections: epidemiology, mechanisms of infection and treatment options.

  • Nat Rev Microbiol. Author manuscript; available in PMC 2016 May 1.
  • Urinary tract infections (UTIs) are a severe public health problem and are caused by a range of pathogens, but most commonly by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus. High recurrence rates and increasing antimicrobial resistance among uropathogens threaten to greatly increase the economic burden of these infections.

Recurrent Urinary Tract Infections Management in Women

  • Sultan Qaboos Univ Med J. 2013 Aug; 13(3): 359–367.
  • Urinary tract infections (UTIs) are one of the most frequent clinical bacterial infections in women, accounting for nearly 25% of all infections. Around 50–60% of women will develop UTIs in their lifetimes.

Expert Panel Recommendations on Lower Urinary Tract Health of Women Across Their Life Span

  • J Womens Health (Larchmt). 2016 Nov 1; 25(11): 1086–1096.
  • Direct care for UTI in 2000 costs $452.8 million for women (compared with $10.3 million in men).
  • Twenty-five to 44% of women experience recurrent UTI annually.
  • In every racial group, women are 25–50% as likely as men to develop bladder cancer.
  • Three percent experience 3 or more recurrent UTIs within 6 months of their initial infection.

Acute Uncomplicated Urinary Tract Infections

  • From the Cleveland Clinic: Juan N. Kattan, Steven Gordon; Published: November 2013
  • Urinary tract infection (UTI) is the most common bacterial infection in humans.
  • "They account for more 8.6 million physician visits (84% by women) and over 1 million hospital admissions in the United States each year."
  • "Acute uncomplicated cystitis remains one of the most common indications for prescribing antimicrobials to otherwise healthy community-dwelling women and up to 50% of all women experience one episode by 32 years of age."

Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. 

  • Dis Mon. 2003 Feb;49(2):53-70.
  • Urinary tract infections (UTIs) are considered to be the most common bacterial infection.
  • Nearly 1 in 3 women will have had at least 1 episode of UTI requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience 1 UTI during their lifetimes. Specific subpopulations at increased risk of UTI include infants, pregnant women, the elderly, patients with spinal cord injuries and/or catheters, patients with diabetes or multiple sclerosis, patients with acquired immunodeficiency disease syndrome/human immunodeficiency virus, and patients with underlying urologic abnormalities.