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A study was conducted to measure the short-term stability and resilience of the genitourinary microbiota and assess compositional differences in bacteria between midstream voided urine and peri-urethral swab specimens. The researchers recruited 7 pre-menopausal women without Lower Urinary Tract Symptoms (LUTS) and recent antibiotic use to collect urine and swab samples each morning for 17 or 18 consecutive days. An enhanced quantitative urine culture (EQUC) protocol was used to analyze bacterial composition. <br /><br />At the start of the study, no participant reported LUTS. On day 18, one participant developed LUTS and was diagnosed with a urinary tract infection (UTI) caused by Escherichia coli. Using EQUC, the researchers observed the progression of E. coli and the rest of the genitourinary microbiota prior to UTI diagnosis. E. coli first appeared in the peri-urethra and midstream voided urine on Days 8 and 9, respectively, 10 and 9 days before diagnosis. Before E. coli detection, the microbiota at both sites were dominated by Lactobacillus gasseri and several Corynebacterium species. On Day 10, the microbiota composition changed, including a reduction in L. gasseri. In the peri-urethra, E. coli increased daily, reaching >105 colony forming units per milliliter (CFU/mL) by Day 13. In midstream voided urine, E. coli levels remained low during Days 11-14, alongside the detection of Bifidobacterium breve. However, B. breve was no longer observed on Day 15, and E. coli levels increased to >105 CFU/mL and remained at this level through Day 18. Daily urinalysis revealed the presence of microscopic blood in the urine and high nitrate levels on Days 15-18.<br /><br />The study suggests that the development of a UTI is a gradual process, providing ample opportunity for intervention before symptoms develop. The researchers also note that 50% of women will experience at least one UTI in their lifetime and that symptoms can include urgency and frequency of urination, pain or burning during urination, and blood in the urine. UTI diagnosis is dependent on the presence of symptoms and a positive urine culture.
Keywords
genitourinary microbiota
bacterial composition
urinary tract infection
Escherichia coli
Lactobacillus gasseri
Corynebacterium species
colony forming units
Bifidobacterium breve
urinalysis
UTI diagnosis
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