There's a vaccine for chicken pox, measles, mumps … Now, doctors are working to create the very first vaccine to prevent urinary tract infections. It's a problem that affects one in five women, and men can experience the pain as well. The best way to tackle the problem may not be treating it but finding a way to prevent it altogether.

"It's like a knife-twisting pain. You're unable to even do the dishes."

Sharon DeBanardo knows the pain that comes with urinary tract infections, when bacteria invade the kidney, bladder and urinary tract.

"I constantly went every 10 days having a bladder infection and urinary tract infection," DeBarnardo said.

Fifty-three percent of women and 14 percent of men will get a UTI at least once -- that adds up to 1.3 million emergency room visits and 250,000 hospitalizations each year. The only treatment -- antibiotics.

"We're beginning to see increasing resistance to these antibiotics, and that's of particular concern," said Harry Mobley, Ph.D., of the Department of Microbiology and Immunology at University of Michigan Medical School in Ann Arbor.

Dr. Mobley and his team are working on a vaccine to prevent the infections, a $2.5 billion per year problem in the U.S.

"A spray up the nose, a couple doses of this, would protect the bladder," Dr. Mobley said.

After five years of study in mice, researchers found three antigens that protect the mice against bacteria. The next step -- try out the vaccine in humans.

"It would be fabulous," DeBarnardo said of the vaccine.

More tests are needed before there's relief for people like DeBarnardo, but she's hopeful a simple spray could one day solve her painful problem.

Dr. Mobley says the vaccine is still three to five years away from hitting the market.

Vaccine for Urinary Tract Infections: MNBT? -- In-Depth Doctor's Interview

Harry Mobley, Ph.D., professor in the Department of Microbiology and Immunology at the University of Michigan Medical School in Ann Arbor, talks about a vaccine that is in the works for urinary tract infections.

What causes urinary tract infections?

Dr. Harry Mobley: The urinary tract is an enclosed tube, if you will. It has an opening to the body’s surface, and sometimes that is accessible to bacteria. Bacteria get into this normally sterile site and cause inflammation and can persist for days or weeks.

What are some of the symptoms?

Dr. Mobley: Symptoms would be burning, urgency, and in more serious cases, when the bacteria go up to the kidneys, you’ll get fever and flank pain.

Are certain people more prone to them?

Dr. Mobley: Women are much more prone to these infections. About half of all women will have one urinary tract infection during their lifetime. Men also get these infections, in a much smaller percentage, usually during the extremes of life – young boys and old men.

When do women usually get them?

Dr. Mobley: All the time – sexually active women, young girls, pregnant women particularly, and elderly women, throughout their lifetime.

Are antibiotics currently the main treatment for urinary tract infections?

Dr. Mobley: The treatment is antibiotics, and for the most part, this can be effective, but we’re beginning to see increasing resistance to antibiotics in the bacteria that cause these infections, and that’s of particular concern. There are batteries of antibiotics that can’t be used in those cases where they have an infection with an antibiotic-resistant bacterium.

Have you developed a way to prevent urinary tract infections altogether?

Dr. Mobley: We’ve developed a vaccine to prevent these infections. It’s at its early stages, but shows promise.

How would this vaccine work?

Dr. Mobley: Currently, we’re using an intra-nasal vaccine, similar to some of the flu vaccinations where we spray up the nose. A couple of doses of this will protect the bladder.

Who needs to get the vaccine?

Dr. Mobley: You could give it to those people that are prone to infections. First, we’d probably look at more of the student population, particularly those women that have recurrent infections. There’s a certain population that has infections over and over and over again, and these would probably be first on the list.

If you give the vaccine to someone who normally gets urinary tract infections, they would never get them again?

Dr. Mobley: That would be our hope. It’s of course, under development.

How long have you been working on this vaccine?

Dr. Mobley: We’ve worked on this for about five years. I moved to the University of Michigan about five years ago, and one of our goals was to move towards this direction. In our laboratory containing the next generation of scientists, we have worked daily on this for about five years, and now we’re at a stage where we have promising results in animal models of infection, and we hope to move this to humans.

What have the results of your research been so far?

Dr. Mobley: So far, in our studies, we tried to be rational about selecting which of the 5,000 possible proteins in these bacteria might be useful in a vaccine. We ask questions like, ‘What’s on the surface of the bacterium that the immune response could attack?’ ‘What would be antigenic?’ ‘What would form an immune response if given to humans or animals?’ ‘What proteins are produced during an actual infection, not just in a test tube but during an infection?’ We ask about five or six different questions, and then put all these answers together. We came up with about six possible proteins to use in a vaccine, and we tested them one at a time on an animal model infection.

What have been the results?

Dr. Mobley: We selected six antigens that could be used for the vaccine, and we tested them one at a time. Three of these antigens protected against challenge with bacteria, that is, we try to infect the animals after they’ve been vaccinated and then in those situations, they resisted the infection.

What is your next phase?

Dr. Mobley: Our next step would be to combine these proteins into one vaccine. For example, one protein protected in the bladder and one protected in the kidney. We’d like to protect both the bladder and the kidney in the urinary tract, so we can combine these antigens together. The other thing would be to see if our vaccine protects against multiple strains of E. coli that are just out in the community. Another project would be to see if we can get long-lasting protection against vaccination, and then finally, can we take this to clinical trials in humans?

Can this be something that could fight bacteria like MRSA or staph infections?

Dr. Mobley: Right. Principally, we’re talking about E. coli. There are numerous different strains of E. coli that cause these infections, and indeed, E. coli caused about 80 percent of these types of infections. MRSA and other staph do not generally cause these infections, so we’d be looking to protect against different strains of one species with possible applications to other genera of bacteria that cause these infections.

Are there common bacteria this would protect against, as well?

Dr. Mobley: The general idea of the vaccine has actually revealed a possible strategy that can be used for lots of different bacteria. We haven’t talked about this yet, but all of the proteins that I’ve described today are ones in which the bacteria can aquire iron molecules from the host that are required for the bacteria to live, so this general strategy could be applied to other bacteria that also need to require iron for growth.

When will we actually see a UTI vaccine?

Dr. Mobley: The clinical trial process, obviously, is a very methodical process where you need to take the stages through safety and immunogenicity, and then finally, we would use a trial that would actually vaccinate people and see if they’re protected naturally against urinary tract infection. This generally takes five to ten years to come to market.

Are there any safety issues that you’ve come across, so far?

Dr. Mobley: The body seems to be able to tolerate a number of vaccines. We, of course, vaccinate children with tens or twenties of vaccines, and the human body is able to handle these. The human body could make a million different immune responses to different molecules, so we have no concerns that this one additional vaccine would be a problem. In addition, we’re targeting a specific group of women with recurrent urinary tract infection.

Is there concern that if we vaccinate people against particular strains of E. coli or other bacteria that other bacteria could come in and fill that niche?

Dr. Mobley: There always is that possibility, but it hasn’t been a great concern thus far. There are small examples where people have been vaccinated for ear infections or other types of infections where other strains have now come and filled that niche, but this is a rarer occurrence.

How did you come up with this vaccine project?

Dr. Mobley: We had worked on the general concept of what is called molecular pathogenesis, how E. coli cause an infection, and we had made great progress on understanding how the infections occur. Now, we felt that we’d like to go from the bench to the bedside where we could now prevent infections, so this was a motivation for starting these studies.

What else are you working on?

Dr. Mobley: We’re working on catheter-associated bacteria. Elderly people that have urinary catheters in place have a completely different set of bacteria that cause these infections – some that cause kidney stones to form – so we’re trying to create vaccines against some of these organisms, as well.