Recurrent urinary tract infection: Association of clinical profiles with urobiome composition in women

Burnett, Lindsey A.; Hochstedler, Baylie; Weldon, Kelly C.; Wolfe, Alan J.; Brubaker, Linda

doi:10.1002/nau.24707

Cited by 27 publications

(17 citation statements)

References 32 publications

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“…A decade after bacterial 16S rRNA gene sequences were detected in female urine samples [ 5 ] and live microorganisms were cultured using extended quantitative urine culture (EQUC) from samples classified as negative by standard urinary culture techniques [ 6 ], the existence of human urinary microbiota (UM) is now widely accepted. Changes in the UM have been observed in association with bladder dysfunction caused by spinal cord injury [ 7 ], lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia [ 8 ], clinical profiles of LUTS in female recurrent urinary tract infections [ 9 ], painful conditions of the urinary bladder known as interstitial cystitis [ 10 ] and chronic prostatitis/chronic pelvic pain syndrome [ 11 ] and even bladder cancer [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Bladder Microbiota Are Associated with Clinical Conditions That Extend beyond the Urinary Tract

et al. 2022

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Background. Since the discovery of the human urinary microbiota (UM), alterations in microbial community composition have been associated with various genitourinary conditions. The aim of this exploratory study was to examine possible associations of UM with clinical conditions beyond the urinary tract and to test some of the conclusions from previous studies on UM. Methods. Catheterised urine samples from 87 men were collected prior to endoscopic urological interventions under anaesthesia. The composition of the bacterial community in urine was characterized using the hypervariable V4 region of the 16S rRNA gene. Samples from 58 patients yielded a sufficient amount of bacterial DNA for analysis. Alpha diversity measures (number of operational taxonomic units, ACE, iChao2, Shannon and Simpson indices) were compared with the Kruskal–Wallis test. Beta diversity (differences in microbial community composition) was assessed using non-metric dimensional scaling in combination with the Prevalence in Microbiome Analysis algorithm. Results. Differences in bacterial richness and diversity were observed for the following variables: age, diabetes mellitus, dyslipidemia, smoking status and single-dose preoperative antibiotics. Differences in microbial community composition were observed in the presence of chronic kidney disease, lower urinary tract symptoms and antibiotic prophylaxis. Conclusions. UM appears to be associated with certain clinical conditions, including those unrelated to the urinary tract. Further investigation is needed before conclusions can be drawn for diagnostics and treatment.

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Section: Introductionmentioning

confidence: 99%

Bladder Microbiota Are Associated with Clinical Conditions That Extend beyond the Urinary Tract

et al. 2022

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“…Both, expanded urinary culture and 16S rRNA gene sequencing have proven that a microbial community exists in the bladder of healthy women [4][5][6][7][8][9][10]. Consequently, some studies have started to investigate its role in certain urogenital conditions [11][12][13]. Yet, knowledge about physiological attributes of urinary microbiota as a prerequisite for studying specific alterations and dynamics associated with diseases is still limited [14].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal variability in the urinary microbiota of healthy premenopausal women and the relation to neighboring microbial communities: A pilot study

Biehl

Farowski

et al. 2022

PLoS ONE

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Background The understanding of longitudinal changes in the urinary microbiota of healthy women and its relation to intestinal microbiota is limited. Methods From a cohort of 15 premenopausal women without known urogenital disease or current symptoms, we collected catheter urine (CU), vaginal and periurethral swabs, and fecal samples on four visits over six months. Additionally, ten participants provided CU and midstream urine (MU) to assess comparability. Urine was subjected to expanded culture. 16S rRNA gene sequencing was performed on all urine, fecal, and selected vaginal and periurethral samples. Sequence reads were processed (DADA2 pipeline) and analyzed using QIIME 2 and R. Results Relative abundances of urinary microbiota were variable over 6–18 months. The degree of intraindividual variability of urinary microbiota was higher than that found in fecal samples. Still, nearly half of the observed beta diversity of all urine samples could be attributed to differences between volunteers (R2 = 0.48, p = 0.001). After stratification by volunteer, time since last sexual intercourse was shown to be a factor significantly contributing to beta diversity (R2 = 0.14, p = 0.001). We observed a close relatedness of urogenital microbial habitats and a clear distinction from intestinal microbiota in the overall betadiversity analysis. Microbiota compositions derived from MU differed only slightly from CU compositions. Within this analysis of low-biomass samples, we identified contaminating sequences potentially stemming from sequencing reagents. Conclusions Results from our longitudinal cohort study confirmed the presence of a rather variable individual urinary microbiota in premenopausal women. These findings from catheter urine complement previous observations on temporal dynamics in voided urine. The higher intraindividual variability of urinary microbiota as compared to fecal microbiota will be a challenge for future studies investigating associations with urogenital diseases and aiming at identifying pathogenic microbiota signatures.

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“… McDonald et al (2017) showed that 100% of symptomatic patients with UTI had NGS positive test results for urinary bacteria, compared with a positive rate of 30% in SUC. Burnett et al (2021) found that expanded quantitative urine culture (EQUC) could detect more urinary microbes than SUC, and their urobiome compositions were associated with distinct clinical profiles in patients with RUTI. Hochstedler et al (2022) showed that EQUC detected more uropathogens than SUC from catheterized and voided urine in patients with RUTI.…”

Section: Introductionmentioning

confidence: 99%

Differential Urinary Microbiota Composition Between Women With and Without Recurrent Urinary Tract Infection

Huang

Zheng

et al. 2022

Front. Microbiol.

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BackgroundRecurrent urinary tract infection (RUTI) is common and burdensome in women. Due to the low concentration or slow-growing of uropathogens in RUTI, standard urine cultures (SUCs) are often negative. Next-generation sequencing (NGS) of bacterial 16S rRNA gene is more sensitive and could be used to reveal the differential microbiota between patients with RUTI and asymptomatic controls.MethodsWomen (aged ≥ 18 years) with clinically diagnosed RUTI with negative SUC and age-matched women asymptomatic controls with normal urinalysis were enrolled. Their midstream voided urine specimens were collected and processed for NGS (Illumina MiSeq) targeting the bacterial 16S rRNA gene V3-V4 region. The dataset was clustered into operational taxonomic units (OTUs) using QIIME. Taxonomic analysis, alpha diversity, beta diversity, multivariate statistical analysis, and linear discriminant analysis effect size (LEfSe) for differential analysis were performed and compared between patients with RUTI and asymptomatic controls.ResultsA total of 90 patients with RUTI and 62 asymptomatic controls were enrolled in this study. Among them, 74.4% (67/90) and 71.0% (44/62) were successfully amplified and sequenced their bacterial 16S rRNA gene. In the alpha diversity analysis, the chao1 index and observed species index were significantly lower in the RUTI group than in the control group (P = 0.015 and 0.028, respectively). In the beta diversity analysis, there was a significant difference between the 2 groups [Analysis of similarities (ANOSIM), R = 0.209, P = 0.001]. The relative abundance of 36 bacterial taxa was significantly higher, and another 24 kinds of bacteria were significantly lower in the RUTI group compared with the control group [LEfSe analysis, P < 0.05, linear discriminative analysis (LDA) score > 3], suggesting that Ralstonia, Prevotella, Dialister, and Corynebacterium may play an important role in RUTI.ConclusionThe urinary microbiota of women with clinically diagnosed RUTI were significantly different from age-matched asymptomatic controls.

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Recurrent urinary tract infection: Association of clinical profiles with urobiome composition in women

Cited by 27 publications

References 32 publications

Bladder Microbiota Are Associated with Clinical Conditions That Extend beyond the Urinary Tract

Bladder Microbiota Are Associated with Clinical Conditions That Extend beyond the Urinary Tract

Longitudinal variability in the urinary microbiota of healthy premenopausal women and the relation to neighboring microbial communities: A pilot study

Differential Urinary Microbiota Composition Between Women With and Without Recurrent Urinary Tract Infection

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