MP20-07 ALL ASYMPTOMATIC BACTERIURIA, ALL THE TIME

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder II1 Apr 2015MP20-07 ALL ASYMPTOMATIC BACTERIURIA, ALL THE TIME Suzanne Groah, Marcos Perez-Losada, Ljubica Caldovic, Inger Ljungberg, Bruce Sprague, Eduardo Castro-Nallar, Neel Shah, Michael Hsieh, and Hans Pohl Suzanne GroahSuzanne Groah More articles by this author , Marcos Perez-LosadaMarcos Perez-Losada More articles by this author , Ljubica CaldovicLjubica Caldovic More articles by this author , Inger LjungbergInger Ljungberg More articles by this author , Bruce SpragueBruce Sprague More articles by this author , Eduardo Castro-NallarEduardo Castro-Nallar More articles by this author , Neel ShahNeel Shah More articles by this author , Michael HsiehMichael Hsieh More articles by this author , and Hans PohlHans Pohl More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.979AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Asymptomatic bacteriuria (ABU) is a poorly understood state frequently confused for pathologic urinary tract infection (UTI), thus leading to overtreatment with antimicrobials. This is particularly problematic in populations with underlying urinary disease, many requiring catheterization, which contributes to heightened risk of ABU and UTI. METHODS This is a cross-sectional study of asymptomatic subjects with normally functioning bladders (non-NB) and with neuropathic bladder (NB). Urine was obtained using the subject's usual method of urine elimination (void, intermittent catheterization or suprapubic catheterization). Samples were assessed using 16S rRNA pyrosequencing combined with Pathoscope 2.0 and STAMP analysis, urinalysis and urine culture. RESULTS All patients regardless of bladder status and gender had bacteriuria based on 16s rRNA pyrosequencing with only 20/47 having positive urine cultures. Unique urine microbiomes were characterized for all subjects and grouped according to subject characteristics. Non-NB females had urine microbiomes featuring Lactobacillus (L. crispatus and L. iners), non-NB males had urine microbiomes containing Streptococcus, while NB subjects had urine microbiomes noteworthy for Enterococcus (Enterococcus faecalis) and Enterobacteria (Proteus mirabilis and Klebsiella pneumonia). CONCLUSIONS Our data change the paradigm of ABU from being a rare and episodic event to a universal phenomenon across gender and bladder status. Although our data is cross-sectional, the fact that all patients had molecularly detectable bacteria, regardless of bladder neurologic status and culture results, strongly suggests that ABU is a normal and universal status in humans. Thus, this suggests that future diagnostic and therapeutic approaches may involve the manipulation of the microbiome from dys- to eubiosis. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e225 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Suzanne Groah More articles by this author Marcos Perez-Losada More articles by this author Ljubica Caldovic More articles by this author Inger Ljungberg More articles by this author Bruce Sprague More articles by this author Eduardo Castro-Nallar More articles by this author Neel Shah More articles by this author Michael Hsieh More articles by this author Hans Pohl More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...