UTI / Bladder Microbiome

<p><a href="https://www.amjmed.com/article/S0002-9343(16)30861-0/pdf">UTI Infection and the Microbiome</a></p>

<hr />

<p>VIDEOS</p>

<h4 class="style-scope ytd-playlist-panel-video-renderer"><a href="https://www.youtube.com/watch?v=4OGd35nMB38"><span id="video-title" class="style-scope ytd-playlist-panel-video-renderer" title="Effect of the urinary micro biome on sacral neuromodulation in women with UI">Effect of the urinary micro biome on sacral neuromodulation in women with UI</span></a></h4>

<h4 class="style-scope ytd-playlist-panel-video-renderer"><span id="video-title" class="style-scope ytd-playlist-panel-video-renderer" title="The bladder urothelium in urinary microbiome brain crosstalk"><a href="https://www.youtube.com/watch?v=MCIelQFOP_M">The bladder urothelium in urinary microbiome brain crosstalk</a></span></h4>

<h4 class="style-scope ytd-playlist-panel-video-renderer"><span id="video-title" class="style-scope ytd-playlist-panel-video-renderer" title="The human micro biome and probiotics on bladder health">The human micro biome and probiotics on bladder health</span></h4>

</div>

<p>From Amy Proal:</p>

<p>Until recently the bladder was regarded as completely sterile and immuno-privileged. In fact, the bladder wasn’t included in the first human microbiome sequencing. In just the last few years, computer based tools have discovered a bladder microbiome.</p>

<p>From the paper “Culturing of the Female Bladder”:</p>

<p>“Contrary to medical dogma, urine is not sterile. Even in asymptomatic individuals.”</p>

<p>What happens to the bladder in a UTI (urinary tract infection)? Sometimes people are given an antibiotic based on symptoms but sometimes a urinary analysis is done and that’s sent to a lab where it’s cultured and researchers look for one pathogen, E. coli. Sometimes if the UTI is deemed to be complicated they’ll culture a handful of other bacteria.</p>

<p>“For over 60 years the standard urine culture protocol has represented the primary tool for detecting bacteria in clinical microbiology laboratories. This aerobic protocol is particularly effective at detecting abundant E. coli but little else.”</p>

<p>When we turned the new computer based tools onto patients with urinary tract infections (see the paper : Microbial Metagenesis of Urinary Tract Infection ) here’s what was found in urine samples taken from patients with UTIs:</p>

<p>Most of these species are pathogens or pathobionts. You can see Enterobacter, chlamydia species, urea plasma, mycoplasma, pseudomonas aeruginosa, prevotella, campylobacter, proteus, babesia, etc. Not every urine sample contained all of these bacteria. The chart represents to totality of over 100 urine samples, but still, each sample contained on average, 41 different species. Additionally, about 2 fungal species and about 3 viral species. The fungal species included Candida albicans, Candida glabrata, Candida tropicalis, Malassezia, and a number of other fungal species. The viruses found in different UTI samples included Human Papilloma Virus, Herpes virus 6, etc.</p>

<p>It doesn’t appear that a UTI is driven by a single pathogen, it could be a polymicrobial condition, or a condition drive by different pathobionts interacting together. Not every urine sample contained the same mix of pathogens. Bacteria, viruses, fungi can often act together to drive infection. Patients with the same symptoms can have different microbe combinations.</p>

<p>A UTI is often a chronic inflammatory condition in the sense that many UTIs are recurrent. Antibiotics will knock down some pathogens in the mix, but a couple months later they get another UTI and the cycle repeats.</p>

<p>Another study looked at 161 different bacteria that were capable of persisting in the urine and they found 457 different bacteriophages that were capable of infecting those species of bacteria in the urine. 86% of the bacterial genomes that were examined contained at least one bacteriophage sequence in them, they were infected with bacteriophages.</p>

<p>In interstitial cystitis, when urine samples are sent to a standard lab they don’t find any microbes. The urine is believed to be sterile. What that has led to is interstitial cystitis has been lumped into the category of autoimmune diseases and there are even websites that imply psychological issues contribute to it. Our new understanding of the bladder microbiome revolutionizes our ability to study and understand this condition. One study found that the urinary microbiome in patients with interstitial cystitis was less diverse, less likely to contain Lactobacillus species and associated with higher levels of proinflammatory cytokines than that of healthy subjects.</p>

UTI / Bladder Microbiome

Attachments