The Urinary Microbiome

Chai, Toby C.; Wolfe, Alan J.; Brubaker, Linda

doi:10.1016/j.idc.2024.03.003

Infectious Disease Clinics of North America

2024

DOI: 10.1016/j.idc.2024.03.003

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The Urinary Microbiome

Toby C. Chai,

Alan J. Wolfe,

Linda Brubaker

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2024

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Cited by 3 publications

References 31 publications

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Rapid and accurate testing for urinary tract infection: new clothes for the emperor

Moreland,

Brubaker,

Tinawi

et al. 2024

Clin Microbiol Rev

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SUMMARY Urinary tract infection (UTI) is among the most common infections in clinical practice. In some cases, if left untreated, it can lead to pyelonephritis and urosepsis. In other cases, UTI resolves without treatment. Clinical diagnosis is typically based on patient symptoms and/or urinalysis, including urine dipsticks. The standard urine culture method is sometimes employed to identify the suspected urinary pathogen (uropathogen) and/or guide antimicrobial choice, but results are rarely available before 24 h. The standard urine culture method also misses fastidious, anaerobic, and slow-growing uropathogens and rarely reports polymicrobial infections. The unexplained combination of negative urine cultures with persistent urinary tract symptoms is distressing to both patients and clinicians. Given the broad appreciation of the advantages provided by rapid testing (e.g., for COVID-19 or influenza A), a rapid, accurate diagnostic test is needed to deliver timely treatment to patients seeking care for UTI that optimizes antibiotic stewardship. Herein, we discuss progress being made toward an accessible, timely (i.e., within hours), accurate assay with results that are clinically useful for the treating clinician within the timeframe of the infection (i.e., the growth rate of the pathogen(s)). New and emerging uropathogens often overlooked by current diagnostic techniques are also reviewed.

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Rapid and accurate testing for urinary tract infection: new clothes for the emperor

Moreland,

Brubaker,

Tinawi

et al. 2024

Clin Microbiol Rev

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Urinary tract infection: is it time for a new approach considering a gender perspective and new microbial advances?

González,

Robino,

Zunino

et al. 2024

Front. Urol.

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Urinary tract infections (UTIs) are among the most common bacterial infections in humans, particularly affecting women, with significant clinical and socioeconomic impacts. Despite advances in medical research, the diagnostic criteria for UTI have remained practically unchanged since Kass’s seminal work, emphasizing the need for a reevaluation in light of new scientific insights. Recent studies have highlighted the importance of the urobiome, a previously underappreciated community of microorganisms within the urinary tract (UT), and its role in maintaining urogenital health. The gut-bladder axis has emerged as a critical pathway in understanding UTI as a dysbiosis, where imbalances in the microbial community and its relation with the host contribute to infection susceptibility. This review explores the evolving definitions and diagnostic challenges of UTI, particularly in women, and examines the implications of recent discoveries on the urobiome and the gut-bladder axis. Additionally, we discuss the potential of novel therapeutic strategies to restore microbial balance, offering a promising avenue for the therapeutic management of UTIs.

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Gut Microbiome Implication and Modulation in the Management of Recurrent Urinary Tract Infection

Brigida,

Saviano,

Petruzziello

et al. 2024

Pathogens

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Urinary tract infections (UTIs) are one of the most common bacterial infections, affecting more than 150 million people each year in the world. UTIs have grown exponentially in the last few years. They represent a major load for both individuals and society. The highest incidence (about 55–60%) concerns women. Many pathogens are involved in UTIs, most of which are derived from the gut. Recent studies, together with recent diagnostic techniques (such as quantitative culture of urine or next-generation sequencing), have improved the knowledge of microbial communities in the urinary tract. It turned out that gut dysbiosis is strictly involved in the pathogenesis of UTIs. In particular, the human gut is the natural habitat for Escherichia coli (E. coli), the main bacterium responsible for UTIs. The overgrowth of E. coli pathogenic strains represents a risk factor for them. Furthermore, the human gut microbiota acts as a “global reservoir” for genes conferring resistance to clinically relevant antibiotics, thus influencing the treatment of UTIs. In addition, differently from the past, the idea of a sterile urinary environment has been replaced by the characterization of a urinary microbiome. The aim of our review is to explore recent studies on the association between gut microbiota and urinary microbiome and to summarize the current knowledge about the effects of interactions between gut and urinary microbial communities in the pathogenesis of UTIs, considering UTIs more as a “gut disease” and not only a urinary disease and providing new insight into the therapeutic options such as the use of probiotics.

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The Urinary Microbiome

Cited by 3 publications

References 31 publications

Rapid and accurate testing for urinary tract infection: new clothes for the emperor

Rapid and accurate testing for urinary tract infection: new clothes for the emperor

Urinary tract infection: is it time for a new approach considering a gender perspective and new microbial advances?

Gut Microbiome Implication and Modulation in the Management of Recurrent Urinary Tract Infection

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