MICROBIOME IN 2018

Urobiome updates: advances in urinary microbiome research

Since the discovery and confirmation of the human urobiome, highly influential studies to characterize this microbial community and understand how it relates to human health and disease have been undertaken. Technological advances will improve information about the status of the urobiome for clinicians.

Key advances

  • Lactobacillus predominance does not differ between adult women with mixed urinary incontinence and age-matched asymptomatic women, but some members of the genus Lactobacillus might be associated with urinary symptoms5.

  • Preoperative assessment of the urinary microbiome could reduce bothersome urinary symptoms following surgery and reduce risk of perioperative urinary tract infection6.

  • Public databases are inadequate for studies of the urobiome and its relationship to bladder health and disease because these databases lack urobiome-specific genomes7.

  • Men with more severe urinary symptoms are more likely to have detectable bladder bacteria than those with less severe or no symptoms. Voided urine does not adequately characterize the male bladder urobiome, and catheterized urine should be used instead8.

  • The urobiome differs between individuals with bladder cancer and those without10.

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Fig. 1: Functional diversity between genomes of bacterial strains isolated from the bladder, vagina and intestine.

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Acknowledgements

This work was supported by NIH grant 5R01DK104718-03 to A.J.W. and L.B.

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Correspondence to Alan J. Wolfe.

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Competing interests

A.J.W. discloses Investigator Initiated Study funds from Astellas Scientific and Medical Affairs and Kimberly Clark Corporation. L.B. discloses editorial stipends from JAMA, Female Pelvic Medicine and Reconstructive Surgery and UpToDate.

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Wolfe, A.J., Brubaker, L. Urobiome updates: advances in urinary microbiome research. Nat Rev Urol 16, 73–74 (2019). https://doi.org/10.1038/s41585-018-0127-5

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