The UTI microbiome and persistent human pathogens
Channel: Amy Proal
Date: 2018-11-19

Here I use the bladder + urinary tract infection (UTI) microbiome as an example of how many bacteria, viruses, fungi and bacteriophages can persist in an area of the body previously deemed "sterile."

Take a look at the extensive range of pathogens + pathobionts capable of persisting in the urine of a patient with a UTI. Since UTIs often become chronic relapsing/remitting conditions, this is a clear example of a persistent inflammatory condition driven by infection.

The UTI data supports two major trends associated with persistent infection in many chronic conditions:

1. Different pathogens (bacteria, viral, fungal etc) may ACT TOGETHER to drive chronic inflammatory symptoms

2. Patients with the same diagnosis may not have to harbor the exact same "mix" of these pathogens to present with similar symptoms

Also research on conditions like Interstitial Cystitis (often deemed autoimmune or "psychosomatic") should strongly benefit from studies showing the bladder is filled with microbes + viruses. We can use this new data to better understand the root cause of persistent inflammation and symptoms.

One correction: In the UTI microbiome study, an average of 41 bacterial genera were identified in each urine sample ( not 41 bacterial species).

Here are links to the studies discussed:

Culturing of female bladder bacteria reveals an interconnected urogenital microbiota:

https://www.nature.com/articles/s41467-018-03968-5

Microbial metagenome of urinary tract infection:

https://www.nature.com/articles/s41598-018-22660-8

Bacteriophages of the Urinary Microbiome:

https://jb.asm.org/content/200/7/e00738-17