Zusammenfassung
Rezidivierende Harnweginfektionen (HWI) sind ein häufiges Problem in der urologischen Praxis. Bei einer antibiotischen Langzeitprophylaxe (LP) muss mit einer Selektion resistenter Darmbakterien gerechnet werden und nach Abschluss der LP treten die häufigen HWI-Frequenzen wieder auf. Durch allgemeine Empfehlungen konnte in kontrollierten Studien eine Rezidivfreiheit nachgewiesen werden. Eine dieser Empfehlungen ist die Einnahme von Cranberry (Moosbeere). Sowohl die Literaturrecherche in Pubmed als auch das kürzlich erschienene „Cochrane Database Systematic Review“ bestätigen Hinweise, dass der tägliche Konsum von Cranberry-Extrakten HWI verhindern soll. In-vitro-Studien zeigen, dass die Bindungsfähigkeit insbesondere der p-Fimbrien der Escherichia coli mit den Uroepithelzellen durch die Anwesenheit von Proanthocyaniden, den wirksamen Inhaltsstoffen der Cranberry, verhindert werden kann. In klinischen Studien ist die Evidenz nicht so ausgeprägt. Viele Bakterien besitzen zwar Fimbrien, aber nur wenige Subpopulationen besitzen p-Fimbrien, P-Fimbrien sind bei Escherichia coli hingegen wesentlich häufiger, wodurch die Adhäsion verhindert werden kann. Allerdings konnten randomisierte und kontrollierte Studien zeigen, dass in der Subanalyse Frauen mit rezidivierenden HWI dennoch profitierten.
Abstract
Recurrent urinary tract infections are a frequent problem in urological practice. Long-term antibiotic prophylaxis can cause resistance of some intestinal bacteria, and after therapy is stopped, infections often resume. In controlled studies, general recommendations for prophylaxis were shown to inhibit reinfection. One of these recommendations is the consumption of cranberries. A review of the literature in PubMed as well as the recently published Cochrane database systematic review confirmed that daily consumption of cranberries prevents recurrent urinary tract infections. In vitro studies have shown that binding of the P fimbriae of Escherichia coli to the uroepithelial tissue can be inhibited in the presence of proanthocyanidins, the active ingredient of cranberries. In clinical studies, the evidence is not so pronounced. Many other bacteria have fimbriae, but only a few subpopulations have P fimbriae. P fimbriae are frequent in E. coli, so this adhesion can be prevented. However, in a subanalysis of randomized and controlled studies, it was shown that women with recurrent urinary tract infections might profit from consuming cranberries.
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Mathers, M., von Rundstedt, F., Brandt, A. et al. Mythos oder Wahrheit. Urologe 48, 1203–1209 (2009). https://doi.org/10.1007/s00120-009-2051-z
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DOI: https://doi.org/10.1007/s00120-009-2051-z