The urinary microbiota of men and women and its changes in women during bacterial vaginosis and antibiotic treatment

Cornelia Gottschick,Clarissa Masur,Christoph Abels,Marius Vital,Dietmar H Pieper,Zhi-Luo Deng,Irene Wagner-Döbler

doi:10.1186/s40168-017-0305-3

Cornelia Gottschick, Clarissa Masur + Show 5 more

Open Access

https://doi.org/10.1186/s40168-017-0305-3

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Abstract

BackgroundThe urinary microbiota is similarly complex as the vaginal and penile microbiota, yet its role as a reservoir for pathogens and for recurrent polymicrobial biofilm diseases like bacterial vaginosis (BV) is not clear.ResultsHere, we analysed the urinary microbiota of healthy men and women and compared it with that of women during BV and after antibiotic treatment using next-generation sequencing of the 16S rRNA gene V1-V2 regions. Eight different community types, so called urotypes (UT), were identified in healthy humans, all of which were shared between men and women, except UT 7, dominated in relative abundance by Lactobacillus crispatus, which was found in healthy women only. Orally applied metronidazole significantly reduced Shannon diversity and the mean relative abundance of Gardnerella vaginalis, Atopobium vaginae, and Sneathia amnii, while L. iners increased to levels twofold higher than those found in healthy women. Although individual urine microbial profiles strongly responded to the antibiotic, the healthy community could not be restored. The correlation between urinary and vaginal fluid microbiota was generally weak and depending on UT and BV status. It was highest in UT 1 in acute BV (59% of samples), but after metronidazole treatment, only 3 out of 35 women showed a significant correlation between their urinary and vaginal microbiota composition.ConclusionsUrethra and bladder thus harbor microbial communities distinct from the vagina. The high abundance of BV related species in the urine of both men and women suggests that urine may act as a reservoir of pathogens and contribute to recurrence.Trial registrationClinicalTrials.gov, NCT02687789

Highlights

The urinary microbiota is complex as the vaginal and penile microbiota, yet its role as a reservoir for pathogens and for recurrent polymicrobial biofilm diseases like bacterial vaginosis (BV) is not clear
Eighty-four percent of patients were of Caucasian origin and 12% were of African descent
This study indicates that the male urine microbiota formed a subgroup of the female urinary microbiota rather than a separate cluster, suggesting that it was not strongly influenced by the distal regions of the urogenital tract

Summary

Introduction

The urinary microbiota is complex as the vaginal and penile microbiota, yet its role as a reservoir for pathogens and for recurrent polymicrobial biofilm diseases like bacterial vaginosis (BV) is not clear. The dogma of sterile urine and bladder persisted for a long time and was based on the assumption that all bacteria are pathogens and absent in healthy people [1]. This paradigm has shifted, and the importance of commensal organisms for human health is widely acknowledged. Different body sites have since been studied extensively, but only recently the female urinary microbiota (FUM) attracted attention [2]. A recent study identified six urotypes in the healthy midstream FUM; they were dominated in abundance by Lactobacillus, Gardnerella, Sneathia, Staphylococcus or Enterobacteriaceae or consisted of highly diverse microbiota [5]. It was shown that urinary bacteria are viable, and midstream urine contains a mixture of urinary and genital tract bacteria [6, 10]

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