Abstract
The application of next generation sequencing techniques has allowed the characterization of the urinary tract microbiome and has led to the rejection of the pre-established concept of sterility in the urinary bladder. Not only have microbial communities in the urinary tract been implicated in the maintenance of health but alterations in their composition have also been associated with different urinary pathologies, such as urinary tract infections (UTI). Therefore, the study of the urinary microbiome in healthy individuals, as well as its involvement in disease through the proliferation of opportunistic pathogens, could open a potential field of study, leading to new insights into prevention, diagnosis and treatment strategies for urinary pathologies. In this review we present an overview of the current state of knowledge about the urinary microbiome in health and disease, as well as its involvement in the development of new therapeutic strategies.
Highlights
The human body is colonized by at least the same number of microorganisms than somatic cells
The first studies on the male urobiome characterized the microbial community in midstream urine and urethral swab samples in patients with and without sexual transmitted infections. 16S rRNA gene amplification and sequencing made it possible to describe the presence of a male urinary microbial community in healthy individuals, as well as a dysbiosis associated with disease (Nelson et al, 2010; Dong et al, 2011)
The growing relevance of the study of the urinary microbiome stems from the fact that alterations in its composition have been associated with the development of different diseases, such as urinary tract infection, renal carcinoma, urgency urinary incontinence, overactive bladder, among others
Summary
The human body is colonized by at least the same number of microorganisms than somatic cells. A combination of 16S rRNA gene sequencing along with EQUC would provide a reliable characterization of microbial communities in the urinary tract, since culture-based approaches would allow an approximate bacterial quantification and would be useful as clinically relevant indicators Another relevant problem in urobiome studies is the choice of specific methods for sample collection, since those may affect the obtained results. Not being a sterile collection method, midstream urine samples may contain microbial contamination with bacteria from the uroepithelium, periurethra or the genital tract, misleading the proper characterization of the urinary bladder microbiome in favor of the urogenital microbiota (Fouts et al, 2012; Modena et al, 2017). For this reason, adding DNA extraction blanks and no-template controls is essential in microbiome studies (Eisenhofer et al, 2019)
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