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

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Authors: Burnett, LA; Hochstedler, BR; Weldon, K; Wolfe, AJ; Brubaker, L
Article Title: Recurrent urinary tract infection: Association of clinical profiles with urobiome composition in women.
Abstract: AIMS: Clinical profiles of women with recurrent urinary tract infection (RUTI) are correlated with their urinary microbes. METHODS: This IRB-approved, cross-sectional study enrolled adult women with RUTI. Urine samples (catheterized and voided) underwent culture by expanded quantitative urine culture (EQUC) and standard urine culture (SUC) methods. A validated symptom questionnaire, relevant clinical variables, and EQUC were used to identify symptom clusters and detect associations with specific urinary microbes. RESULTS: Most (36/43) participants were postmenopausal; the average age was 67 years. 51% reported vaginal estrogen use; 51% reported sexual activity. Although single symptoms were not associated with specific urinary microbes, EQUC results were correlated with five distinct clinical profile clusters: Group A: odor, cloudiness, and current vaginal estrogen use (no culture result association). Group B: frequency, low back pain, incomplete emptying, and vaginal estrogen (significantly increased proportion of Lactobacillus-positive cultures). Group C: pain/burning, odor, cloudiness, and urgency (high proportions of UTI-associated microbe-positive cultures). Group D: frequency, urgency, pain/burning, and current vaginal estrogen use (increased number of no growth cultures). Group E: frequency, urgency, pain/burning, odor, overactive bladder, and sexually active (significantly increased proportion of Klebsiella-positive cultures). CONCLUSIONS: Distinct clinical profiles are associated with specific urinary microbes in women with RUTI. Refined assessments of clinical profiles may provide useful insights that could inform diagnostic and therapeutic considerations.
Journal Title: Neurourology and urodynamics
ISSN: 1520-6777; 0733-2467
Publisher: Wiley Periodicals, Inc  
Date Published: 2021