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 Early research into culturing bacteria in IC/BPS

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Martha Foster

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Join date : 2016-04-04

Early research into culturing bacteria in IC/BPS Empty
PostSubject: Early research into culturing bacteria in IC/BPS   Early research into culturing bacteria in IC/BPS EmptyMon Jul 25, 2016 10:50 pm

Since there are several postings about the reliability of the current lab testing of urine samples and the importance of testing in diagnosing urinary problems, I am writing about the microbiologist who played a key role in finding a better method. I am referring to Dr. Paul Fugazzotto who over 40 years ago made a huge breakthrough on this front. He had a PhD in microbiology and was State Lab Director of the state of Nevada in the USA when he retired. He was born in 1913 and died in 2008. I was fortunate enough to have talked to him frequently on the phone, and I have a video of a talk he gave to doctors and patients in Arizona when he was beginning to provide broth culturing for symptomatic patients who had been told about his work. I later sponsored research into his work by researchers at the Medical College of Virginia. He came out here to give some guidance to the researchers and I was able to ask questions about his findings.

He questioned the accuracy of the current testing, performed in hospitals and lab corporations, that doctors ordered when patients sought help due to various bladder symptoms such as frequency, urgency, and pain in the pelvic area, plus numerous other complaints. These labs often did not find any bacteria or did not find what Dr. Fugazzotto believed were the real pathogens. The reports from these labs said "No growth" or called the bacteria "contaminants". Dr. F. spoke to scientists and doctors working in the field of urology and they dismissed his findings and continued to perform the same tests during the years he was working from his home lab doing broth cultures that were much more accurate.

He knew that some bacteria take longer to grow and so he placed the specimen in a rich soy broth first to encourage growth after purging the specimen by centrifuging it. He allowed longer than 24 hours for growth to show and sometimes waited as long as a week or more. He expected to find the pathogenic bacteria such as Enterococci or other Streptococcus strains. He also did find some other species such as E.coli, Klebsiella, Proteus, and other Gram negative bacteria which could cause symptoms in some bladders, depending on the condition of the bladder. He recommended a relatively short treatment for these "scavengers" as he called them. In the case of the Gram positive bacteria, especially Enterococcus which he found most often, he recommended a much longer treatment, 6 months or even year, since this species could invade the tissue of the bladder.

Having used his culturing as a patient I was amazed at how accurate his recommendations were as far as treatment goes. It was a relief for me to find that bacteria were present and therefore there was something to treat. I had suffered for 2 years and had tried all of the treatments that were available during the 1990's but they did not change my symptoms. He was not an MD so could only recommend a treatment based on the culture report and his long experience with the patient outcomes.

He continued to provide culturing for patients throughout the 1990s and asked for only a small donation so he could continue his research. When he could no longer practice he spent time writing a lab manual spelling out his methods. In addition to the original culture of a patient's urine he continued to monitor it for the level of antibiotic. Since treatment required months he often advised lowering the dosage so that the antibiotic did not build up in the tissues and cause discomfort. He kept records of all patients who used his work and was culturing for patients all over the world. He did not use the colony count believing this was not important in declaring there was an infection.

As we now realize the researchers have new devices to use for molecular testing and are able to identify many more species of bacteria. Intracellular bacterial communities of bacteria are being found. These are likened to biofilms which they now know are found in a majority of chronic infections. These are often polymicrobial and are not easily penetrated by antibiotics. This knowledge was not well known when Dr. Fugazzotto was practicing and will be the wave of the future; but he was the first to make the breakthrough of finding a bacterial component involved in a majority of IC/BPS patients and which many patients are now convinced is/was responsible for the tenacity of their symptoms. Likewise he did not know that biofilms existed in most recurrent urinary tract dysfunction which caused ongoing problems. He deserves recognition for continuing to research his finding of a bacterial component even though the mainstream medical and scientific communites scoffed at this belief. But he was helping patients while doing research in spite of the lack of support. Many patients turned to him and will be forever grateful for his help.
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