Temporal Dynamics of the Adult Female Lower Urinary Tract Microbiota

Abstract

245/250) 24MANUSCRIPT: (5000/5000) 25 ACKNOWLEDGMENTS: We thank Mary Tulke RN for her assistance with participant 35 recruitment. We also acknowledge funding from NIH (R01 DK104718 awarded to AJW 36and LB). The funders did not play a part in the design or conduct of the study. 37 TKP, BW, LB, ERM, and AJW designed the study. TKP and BW recruited participants. 38TKP processed the specimens. TH prepared them for DNA sequencing. RL sequenced 39 the specimens. TKP, BW, QD and AJW analyzed the data. TKP and AJW wrote the 40 manuscript. TKP, BW, TH, RL, LB, QD, ERM, and AJW reviewed and edited the 41 manuscript. 42 43 ABSTRACT 59Temporal dynamics of certain human microbiotas have been described in 60 longitudinal studies; variability often relates to modifiable factors or behaviors. Early 61 studies of the urinary microbiota preferentially used samples obtained by transurethral 62 catheterization to minimize vulvo-vaginal microbial contributions. Whereas voided 63 specimens are preferred for longitudinal studies, the few studies that reported 64 longitudinal data were limited to women with lower urinary tract (LUT) symptoms, due to 65 ease of accessing a clinical population for sampling and the impracticality and risk of 66 collecting repeated catheterized urine specimens in a non-clinical population. Here, we 67 studied the microbiota of the LUT of non-symptomatic, pre-menopausal women using 68 mid-stream voided urine (MSU) specimens to investigate relationships between 69 microbial dynamics and personal factors. Using 16S rRNA gene sequencing and a 70 metaculturomics method called Expanded Quantitative Urine Culture (EQUC), we 71 characterized the microbiotas of MSU and peri-urethral swab specimens collected daily 72 for approximately three months from a small cohort of adult women. Participants were 73 screened for eligibility, including ability to self-collect paired urogenital specimens prior 74 to enrollment. In this population, we found that measures of microbial dynamics related 75 to specific participant-reported factors, particularly menstruation and vaginal 76intercourse. Further investigation of the trends revealed differences in composition and 77 diversity of LUT microbiotas within and across participants. These data, in combination 78 with previous studies showing relationships between the LUT microbiota and LUT 79 symptoms, suggest that personal factors relating to the genitourinary system may be an 80 important consideration in the etiology, prevention, and/or treatment of LUT disorders.

Genomic relatedness and clinical significance of Streptococcus mitis strains isolated from the urogenital tract of sexual partners

“…Quantitatively, however, JSD values revealed a disruption in the stability of the MSU microbiota following vaginal intercourse that approached statistical significance (P=0.109) (Table S1, available with the online version of this article). Qualitative trends in the microbiota were consistent with previous findings, showing an association between participant-reported vaginal intercourse and subsequent detection of Streptococcus species [6]. This trend applied to the MSU ( Fig.…”

“…Instead, researchers have found other, mainly Gram-positive, non-pathogenic organisms in female urine specimens following vaginal intercourse, including Corynebacterium, Staphylococcus and Streptococcus [23]. These findings are consistent with data published by our group [6], where we found increased abundance of Streptococcus species in LUT specimens following participant-reported vaginal intercourse.…”

“…2 shows the relative abundance of the microbiota as assessed by modified EQUC over time for PARTNER01 (female). As reported in our prior study [6], Lactobacillus and Gardnerella alternately predominated in the female's LUT microbiota. Quantitatively, however, JSD values revealed a disruption in the stability of the MSU microbiota following vaginal intercourse that approached statistical significance (P=0.109) (Table S1, available with the online version of this article).…”

“…In this study, we investigated the relationship between vaginal intercourse and the LUT microbiota. We enrolled a female participant from a prior study [6] and her male sexual partner. As observed in the prior study, the female participant's LUT microbiota alternated every few days between Lactobacillus and Gardnerella predominance (Fig.…”

“…A modified version of the expanded quantitative urine culture (EQUC) protocol was used to identify the microbiota of the specimens [1,6,27]. For the MSU specimens, 0.01 ml (female specimens) or 0.1 ml (male specimens) urine was spread quantitatively onto diverse media types [BAP, CNA agar and CDC anaerobe 5 % BAP (ABAP)] and incubated in appropriate environments at appropriate temperatures (5 % CO 2 at 35 °C for 48 h or anaerobic conditions at 35 °C for 48 h).…”