The urinary microbiome in patients with refractory urge incontinence and recurrent urinary tract infection

Chen, Zhuoran; Phan, Minh-Duy; Bates, Lucy; Peters, Kate M.; Mukerjee, Chinmoy; Moore, Kate H.; Schembri, Mark A.

doi:10.1007/s00192-018-3679-2

Cited by 45 publications

(34 citation statements)

References 17 publications

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“…The frequency of rUTI in older women is not well documented, but it is estimated that 10–15% of women over the age of 60 years experience multiple rUTI episodes 23 . Although persistent infections can occur, in many cases rUTIs result from reinfection by the same organism 20,25,26 . In UTI caused by UPEC, >60% of recurrences can be attributed to the original infecting strain 25 .…”

Section: Introductionmentioning

confidence: 99%

Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection

et al. 2019

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Recurrent urinary tract infections (rUTIs) are extremely common, with ~ 25% of all women experiencing a recurrence within 1 year of their original infection. Escherichia coli ST131 is a globally dominant multidrug resistant clone associated with high rates of rUTI. Here, we show the dynamics of an ST131 population over a 5-year period from one elderly woman with rUTI since the 1970s. Using whole genome sequencing, we identify an indigenous clonal lineage (P1A) linked to rUTI and persistence in the fecal flora, providing compelling evidence of an intestinal reservoir of rUTI. We also show that the P1A lineage possesses substantial plasmid diversity, resulting in the coexistence of antibiotic resistant and sensitive intestinal isolates despite frequent treatment. Our longitudinal study provides a unique comprehensive genomic analysis of a clonal lineage within a single individual and suggests a population-wide resistance mechanism enabling rapid adaptation to fluctuating antibiotic exposure.

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Section: Introductionmentioning

confidence: 99%

Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection

et al. 2019

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“…Urinary tract infections (UTIs), the most prevalent bacterial infection in human adults, are characterized by high levels of recurrence, with~40% of infected individuals experiencing a recurrent UTI (rUTI) within 6 months of the original episode 8,9 . Moreover, a range of 50-80% of rUTI patients are infected repeatedly by the same bacterial strain, indicating the presence of reservoirs within the host [10][11][12] . Disease outcomes are diverse, ranging from asymptomatic bacteriuria (ASB) to symptomatic infection of the bladder (cystitis), and kidneys (pyelonephritis), both of which can progress to bacteremia, or sepsis in vulnerable populations 9,13 .…”

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confidence: 99%

Invasion of vaginal epithelial cells by uropathogenic Escherichia coli

Brannon¹,

Dunigan²,

Beebout³

et al. 2020

Nat Commun

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Host-associated reservoirs account for the majority of recurrent and oftentimes recalcitrant infections. Previous studies established that uropathogenic E. colithe primary cause of urinary tract infections (UTIs)can adhere to vaginal epithelial cells preceding UTI. Here, we demonstrate that diverse urinary E. coli isolates not only adhere to, but also invade vaginal cells. Intracellular colonization of the vaginal epithelium is detected in acute and chronic murine UTI models indicating the ability of E. coli to reside in the vagina following UTI. Conversely, in a vaginal colonization model, E. coli are detected inside vaginal cells and the urinary tract, indicating that vaginal colonization can seed the bladder. More critically, bacteria are identified inside vaginal cells from clinical samples from women with a history of recurrent UTI. These findings suggest that E. coli can establish a vaginal intracellular reservoir, where it may reside safely from extracellular stressors prior to causing an ascending infection.

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“…The UT microbiota represents 21.4% of the known prokaryotic diversity associated with humans and 62.3% of organisms identified in urine can also be found in the human gut microbiota [263]. As has been observed for the gut microbiome [239,243,244], current evidence suggests that microbiota profiles play significant roles in UT disease occurrence and progression [223,[264][265][266][267][268], but extensive additional studies are needed to further elucidate complex host-microbiota interactions within the UT using methods and perspectives that have been applied to other microbiome studies [222,241,242,246]. The presence of soluble, plant-derived, dietary oligosaccharides in urine would be significant in terms of UT health, through both prebiotic effects on UT microbiota and direct biological and chemical effects, and the possible influence of these compounds must be considered in the context of both cranberry and other dietary sources.…”

Section: Cranberry Carbohydrates and Human Microbiotamentioning

confidence: 87%

Oligosaccharides and Complex Carbohydrates: A New Paradigm for Cranberry Bioactivity

Coleman

Ferreira

2020

Molecules

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Cranberry is a well-known functional food, but the compounds directly responsible for many of its reported health benefits remain unidentified. Complex carbohydrates, specifically xyloglucan and pectic oligosaccharides, are the newest recognized class of biologically active compounds identified in cranberry materials. Cranberry oligosaccharides have shown similar biological properties as other dietary oligosaccharides, including effects on bacterial adhesion, biofilm formation, and microbial growth. Immunomodulatory and anti-inflammatory activity has also been observed. Oligosaccharides may therefore be significant contributors to many of the health benefits associated with cranberry products. Soluble oligosaccharides are present at relatively high concentrations (~20% w/w or greater) in many cranberry materials, and yet their possible contributions to biological activity have remained unrecognized. This is partly due to the inherent difficulty of detecting these compounds without intentionally seeking them. Inconsistencies in product descriptions and terminology have led to additional confusion regarding cranberry product composition and the possible presence of oligosaccharides. This review will present our current understanding of cranberry oligosaccharides and will discuss their occurrence, structures, ADME, biological properties, and possible prebiotic effects for both gut and urinary tract microbiota. Our hope is that future investigators will consider these compounds as possible significant contributors to the observed biological effects of cranberry.

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The urinary microbiome in patients with refractory urge incontinence and recurrent urinary tract infection

Cited by 45 publications

References 17 publications

Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection

Population dynamics of an Escherichia coli ST131 lineage during recurrent urinary tract infection

Invasion of vaginal epithelial cells by uropathogenic Escherichia coli

Oligosaccharides and Complex Carbohydrates: A New Paradigm for Cranberry Bioactivity

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