Exploring recurrent urinary tract infection: paired microbiota and culture-based profiling reveals stable dysbiosis and multidrug-resistant, virulence-enriched uropathogens
**Objectives:** Recurrent urinary tract infection (rUTI) is increasingly complicated by antimicrobial resistance (AMR), yet urinary microbiome dysbiosis and isolate-level resistance-virulence are rarely examined together across different treatment states. In this study, we characterized both within the same sample in rUTI and in healthy controls. **Methods:** In this cross-sectional cohort,…
**Objective:** Researchers examined the urinary microbiome in women with recurrent urinary tract infections (rUTI) compared to healthy controls, investigating changes in bacterial composition, antibiotic resistance, and virulence factors.
**Methods:** The study recruited 80 urine samples from women with untreated, treated, and prophylaxis rUTI, as well as age-matched healthy controls at four locations in South India. Of the collected samples, 75 were analyzed using 16S rRNA sequencing (V3-V4 region). Additionally, 105 culturable uropathogens were identified and tested for susceptibility to various antibiotics and assessed for virulence.
**Results:** The rUTI groups exhibited lower alpha diversity compared to the healthy controls (median Shannon diversity index ranging from 1.07-1.18 vs 2.17; statistical significance, p = 0.041). Community structure exhibited significant differences between the rUTI groups and controls (PERMANOVA R-squared = 0.091, p = 0.004; pairwise false discovery rate = 0.008), but no differences existed among the individual rUTI subgroups.
Notably, the relative abundance of Lactobacillus bacteria significantly decreased from 29.2% in healthy controls to lower levels in the rUTI groups.
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