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Recurrent urinary tract infection: Association of clinical profiles with urobiome composition in women
Author(s) -
Burnett Lindsey A.,
Hochstedler Baylie R.,
Weldon Kelly,
Wolfe Alan J.,
Brubaker Linda
Publication year - 2021
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24707
Subject(s) - medicine , urine , urinary system , overactive bladder , odor , estrogen , etiology , lower urinary tract symptoms , microbiological culture , vagina , physiology , gynecology , surgery , pathology , prostate , genetics , alternative medicine , cancer , neuroscience , bacteria , biology
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.