Dormant Microbes in Interstitial Cystitis

Domingue, Gerald J.; Ghoniem, Gamal M.; Bost, Kenneth L.; Fermin, César D.; Human, Liset G.

doi:10.1016/s0022-5347(01)67594-3

Cited by 99 publications

(31 citation statements)

References 19 publications

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“…Although both pathogenic and nonpathogenic bacterial cells were examined in this study, these results impact on hypotheses concerning the etiology of persistent UTIs (and perhaps interstitial cystitis as well [12]), and attempts to explain the urinary tract symptoms in patients without significant bacteriuria. There is increasing evidence that recurrent infections caused by the index strain arise from a reservoir of bacteria that are residing in the urinary tract (33,39,42,44).…”

Section: Discussionmentioning

confidence: 99%

Viable but Nonculturable Bacteria Are Present in Mouse and Human Urine Specimens

et al. 2004

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The presence of viable but nonculturable bacteria in human clean-catch and mouse bladder-isolated urine specimens was investigated. Viable but nonculturable bacteria are alive but do not give rise to visible growth under nonselective growth conditions. Urine specimens obtained from human female volunteers with or without an active urinary tract infection were found to contain, on average, significantly more viable than culturable forms of bacteria. Additional support for the presence of viable but nonculturable cells in urine specimens considered sterile was obtained from examination of urine specimens obtained directly from the bladder of healthy mice. Because the viability assay used to study the viable but nonculturable condition is by necessity growth independent, and hence indirect, the accuracy of this assay that scores cells with intact cell membranes as being viable was studied. Greater than 95% of Escherichia coli cells exposed to lethal doses of UV irradiation were found to lose their membrane integrity within a day, a time frame similar to that used to examine urine specimens. These data suggest that viable but nonculturable cells can occur within regions of the urinary tract previously considered sterile.Urinary tract infections (UTIs) affect as many as 50% of women at least once during their lifetime (29, 32), and 25% of those who acquire a UTI will have another infection within the following 6 months (17). A UTI occurs when the urinary tract is infected with microorganisms, and uropathogenic Escherichia coli accounts for greater than 80% of all UTI cases (4, 30). One method of diagnosing a UTI is by culturing urine specimens; a threshold of 100,000 CFU/ml in clean-catch urine specimens is considered to indicate a UTI (4, 28). This threshold is not an absolute indicator, as both asymptomatic bacteriuria and patients with UTI symptoms having no culturable urine bacteria occur (29,32).Urine within the urinary tract is generally considered sterile (14). This conclusion is based upon a lack of culturable cells present in urine specimens obtained via clean-catch and catheterization methods. The presence of viable bacteria in the urine specimens of healthy patients would impact on hypotheses to explain recurrent UTIs as well as diagnostic procedures. Most recurrent UTIs result from reinfection; however, a higher percentage than would be expected by chance are caused by the index strain (6,18,26,27,41). The physical location and physiological status of index strain cells that remain after successful antibiotic therapy are unknown. Observations with a mouse model indicate that uropathogenic E. coli cells can remain in the urinary tract following antibiotic ther-

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Section: Discussionmentioning

confidence: 99%

Viable but Nonculturable Bacteria Are Present in Mouse and Human Urine Specimens

et al. 2004

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“…Although no conclusive evidence for either bacterial or a viral etiology have been presented [6,7], the role of anaerobes and other fastidious bacteria is still under discussion [8]. Recently, Domingue et al [9] used the polymerase chain reaction (PCR) to detect gram-negative bacterial DNA in bladder biopsies from 4 of 14 IC patients. The present study indicates that the bacterial flora of urethra and bladder of patients with IC clearly differs from that of healthy women.…”

Section: Discussionmentioning

confidence: 99%

Urinary Bacterial Flora of Women with Urethral Syndrome and Interstitial Cystitis

Haarala

Kiilholma²,

Lehtonen³

1999

Gynecol Obstet Invest

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The aerobic and anaerobic bacterial flora in the first voided and in the midstream urine of healthy females (n = 5) and female patients with either urethral syndrome (US) (n = 5) or interstitial cystitis (IC) (n = 14) were studied. Bacteria were grown on media enabling isolation of fastidious and aerobic as well as obligatory anaerobic species. In healthy females only gram-positive rods were found whereas US patients also harbored streptococci. Patients with IC presented also with Enterobacteriae and anaerobic bacteria. Five IC patients with severe symptoms were treated with metronidazole; 2 out of 3 patients with anaerobic bacteria in the pretreatment specimens had no anaerobes after metronidazole therapy and in 1 patient streptococci disappeared after the therapy. One patient with severe symptoms and Bacteroides fragilis in the midstream urine became symptom-free after 2 weeks of metronidazole treatment. Although there is uncertainty whether the US and IC are not related to an infectious etiology, the bacterial flora in urethral and in midstream urine in these conditions differs considerably from that of healthy females.

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“…Urine within the urinary tract has in general been considered sterile [10,11], based upon a lack of culturable microbial cells present in urine specimens obtained by the clean-catch method and by catheterization [12-15]. Confirmation of a UTI relies on demonstrating significant bacteriuria (or funguria) in a voided midstream urine sample.…”

Section: Introductionmentioning

confidence: 99%

Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons

et al. 2011

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BackgroundUrine within the urinary tract is commonly regarded as "sterile" in cultivation terms. Here, we present a comprehensive in-depth study of bacterial 16S rDNA sequences associated with urine from healthy females by means of culture-independent high-throughput sequencing techniques.ResultsSequencing of the V1V2 and V6 regions of the 16S ribosomal RNA gene using the 454 GS FLX system was performed to characterize the possible bacterial composition in 8 culture-negative (<100,000 CFU/ml) healthy female urine specimens. Sequences were compared to 16S rRNA databases and showed significant diversity, with the predominant genera detected being Lactobacillus, Prevotella and Gardnerella. The bacterial profiles in the female urine samples studied were complex; considerable variation between individuals was observed and a common microbial signature was not evident. Notably, a significant amount of sequences belonging to bacteria with a known pathogenic potential was observed. The number of operational taxonomic units (OTUs) for individual samples varied substantially and was in the range of 20 - 500.ConclusionsNormal female urine displays a noticeable and variable bacterial 16S rDNA sequence richness, which includes fastidious and anaerobic bacteria previously shown to be associated with female urogenital pathology.

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Dormant Microbes in Interstitial Cystitis

Cited by 99 publications

References 19 publications

Viable but Nonculturable Bacteria Are Present in Mouse and Human Urine Specimens

Viable but Nonculturable Bacteria Are Present in Mouse and Human Urine Specimens

Urinary Bacterial Flora of Women with Urethral Syndrome and Interstitial Cystitis

Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons

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