Will a vaccine against urinary tract infections become a reality?

Most people have E. coli bacteria in their intestines. 

As long as it stays there, it generally doesn’t cause any problems. 

But if it ends up in other parts of the body, it can lead to infection, such as urinary tract infections (UTIs) and bloodstream infections. 

This can be particularly serious for older people and those with cancer.

A vaccine could reduce antibiotic resistance

Many people are given antibiotics to fight an infection. 

However, the frequent use of antibiotics has led to some variants of E. coli becoming multi-resistant. This means that several types of antibiotics no longer work against them.

This poses a major threat to public health. Researchers therefore hope it will be possible to develop vaccines against the bacterium.

“It could both reduce the use of antibiotics and be of great benefit to people with weakened immune systems, such as older people and cancer patients,” explains Rebecca Gladstone. 

She is a researcher at the University of Oslo's Department of Biostatistics.

One vaccine will not work against all infections

In a new study, she and her research colleagues collected data from 18,000 patient samples in Norway and a number of other countries around the world. 

They studied the details of the bacteria’s genetic material through so-called genome sequencing.

E. coli bacteria do what they can to survive and therefore have a protective capsule around them.

Such capsules are made of different types of sugar layers that the bacteria hide behind to evade our immune system.

And here the researchers encountered a new challenge in the study. They found that there was more variation in this protective system than they had assumed.

“We discovered 90 different variants of such protective capsules on E. coli bacteria. Only a third of these were previously known,” says Gladstone.

Researchers will target vaccines at the most common infections

Nevertheless, a few variants account for half of the urinary tract infections and bloodstream infections in Norway.

These in turn cause many of the infections where the bacterium is resistant, meaning it withstands at least one type of antibiotic.

“The two most common capsules, K1 and K5, mimic human sugar-coated proteins. So these cannot be used directly in vaccines. For bacteria that have these two types of capsules, we therefore have to find other features of the bacterium for the vaccine to target,” says Gladstone.

The researcher says that in Norway, it is still possible to achieve a lot by developing vaccines that target just a few types of protective capsules. In low-income countries, the situation is more complex.

“There they have even greater variation in these protective capsules. In any case, this means we cannot develop just one vaccine that will work against all E. coli bacteria. We will most likely have to focus our efforts on the types that most often cause infections, and those that lead to the most severe infections,” she says.

Researchers must find new ways to kill the bacteria

In the future, we may risk having no treatment options for infections if bacteria become resistant to all life-saving antibiotics.

“In addition to vaccines, we also need to work on developing rapid diagnostics. It will also be important to find methods of killing the bacteria without resorting to large amounts of broad-spectrum antibiotics,” says Gladstone.

Reference:

Gladstone et al. Identification of transporter-dependent capsular loci associated with the invasive potential of Escherichia coli, Nature Microbiology, 2026. DOI: 10.1038/s41564-026-02283-w

About the research

The study was carried out in collaboration with researchers from the Wellcome Sanger Institute and is partly funded by the Trond Mohn Research Foundation.

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