The Bacterial Flora of the Vaginal Vestibule, Urethra and Vagina in the Normal Premenopausal Woman

Pfau, Alphonse; Sacks, T.

doi:10.1016/s0022-5347(17)57976-8

Cited by 56 publications

(21 citation statements)

References 6 publications

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“…Previous studies have shown that the microbial flora of the vaginal vestibule and of the urethra are so similar as to be virtually identical (Fair et al, 1970;Pfau and Sacks, 1977). We confirm this finding and conclude that there is no need to obtain specimens from both sites when investigating periurethral colonization.…”

Section: Discussionsupporting

confidence: 84%

The Role of Periurethral Colonization in the Aetiology of Recurrent Urinary Infection in Women

Cooper

Brumfitt

Hamilton‐Miller

et al. 1980

BJOG

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Summary Periurethral bacterial colonization was studied in two groups of women by taking samples with a polystyrene sponge. Just over half (56 per cent) of 81 sexually‐active women attending a family planning clinic were not colonized in the periurethral area; subjects who were colonized usually showed large numbers of a single bacterial species. On the other hand, all 38 patients who were attending a clinic because of recurrent urinary infections were colonized in the periurethral area; most of these yielded a heavy growth, and more than one bacterial species was usually isolated. Gram‐positive cocci predominated as the colonizing flora in both groups, a finding which is in marked contrast to the predominant aetiological agents in urinary infections, namely Gram‐negative bacilli. We therefore conclude that colonization of the periurethral area is not the decisive event in the initiation of a urinary infection.

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Section: Discussionsupporting

confidence: 84%

The Role of Periurethral Colonization in the Aetiology of Recurrent Urinary Infection in Women

Cooper

Brumfitt

Hamilton‐Miller

et al. 1980

BJOG

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“…While it is well established that in most healthy women of childbearing age the vaginal tract is colonized by Lactobacillus species [54-56], this has not been investigated in women with NB. We too found a clear preponderance of Lactobacillus in healthy control females; however, in addition to the greatest relative abundance of Lactobacillus in healthy control females, there was a progressive reduction in abundance of Lactobacillus in females with NB who void (clean catch sample) or who use intermittent catheterization, and females with NB who use indwelling (Foley) catheters (Figure 3 inset).…”

Section: Discussionmentioning

confidence: 99%

Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury

et al. 2012

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BackgroundClinical dogma is that healthy urine is sterile and the presence of bacteria with an inflammatory response is indicative of urinary tract infection (UTI). Asymptomatic bacteriuria (ABU) represents the state in which bacteria are present but the inflammatory response is negligible. Differentiating ABU from UTI is diagnostically challenging, but critical because overtreatment of ABU can perpetuate antimicrobial resistance while undertreatment of UTI can result in increased morbidity and mortality. In this study, we describe key characteristics of the healthy and ABU urine microbiomes utilizing 16S rRNA gene (16S rDNA) sequencing and metaproteomics, with the future goal of utilizing this information to personalize the treatment of UTI based on key individual characteristics.MethodsA cross-sectional study of 26 healthy controls and 27 healthy subjects at risk for ABU due to spinal cord injury-related neuropathic bladder (NB) was conducted. Of the 27 subjects with NB, 8 voided normally, 8 utilized intermittent catheterization, and 11 utilized indwelling Foley urethral catheterization for bladder drainage. Urine was obtained by clean catch in voiders, or directly from the catheter in subjects utilizing catheters. Urinalysis, urine culture and 16S rDNA sequencing were performed on all samples, with metaproteomic analysis performed on a subsample.ResultsA total of 589454 quality-filtered 16S rDNA sequence reads were processed through a NextGen 16S rDNA analysis pipeline. Urine microbiomes differ by normal bladder function vs. NB, gender, type of bladder catheter utilized, and duration of NB. The top ten bacterial taxa showing the most relative abundance and change among samples were Lactobacillales, Enterobacteriales, Actinomycetales, Bacillales, Clostridiales, Bacteroidales, Burkholderiales, Pseudomonadales, Bifidobacteriales and Coriobacteriales. Metaproteomics confirmed the 16S rDNA results, and functional human protein-pathogen interactions were noted in subjects where host defenses were initiated.ConclusionsCounter to clinical belief, healthy urine is not sterile. The healthy urine microbiome is characterized by a preponderance of Lactobacillales in women and Corynebacterium in men. The presence and duration of NB and method of urinary catheterization alter the healthy urine microbiome. An integrated approach of 16S rDNA sequencing with metaproteomics improves our understanding of healthy urine and facilitates a more personalized approach to prevention and treatment of infection.

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“…We know of no other controlled study on the Several studies have used oral or vaginal application of L. ucidophilus in the treatment or prophylaxis of vaginal candidal infection (1 [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. While there seems to be a clinical effect on the vaginitis, none of the studies demonstrates any change in the lactobacillus content of the microflora of the vagina (1 1-14).…”

Section: Discussionmentioning

confidence: 99%

Vaginal application of lactobacilli in the prophylaxis of recurrent lower urinary tract infection in women

Bærheim

Larsen²,

Digranes

1994

Scandinavian Journal of Primary Health Care

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The Bacterial Flora of the Vaginal Vestibule, Urethra and Vagina in the Normal Premenopausal Woman

Cited by 56 publications

References 6 publications

The Role of Periurethral Colonization in the Aetiology of Recurrent Urinary Infection in Women

The Role of Periurethral Colonization in the Aetiology of Recurrent Urinary Infection in Women

Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury

Vaginal application of lactobacilli in the prophylaxis of recurrent lower urinary tract infection in women

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