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Erschienen in: International Urogynecology Journal 9/2014

01.09.2014 | Original Article

Urinary bacteria in adult women with urgency urinary incontinence

verfasst von: Linda Brubaker, Charles W. Nager, Holly E. Richter, Anthony Visco, Ingrid Nygaard, Matthew D. Barber, Joseph Schaffer, Susan Meikle, Dennis Wallace, Noriko Shibata, Alan J. Wolfe

Erschienen in: International Urogynecology Journal | Ausgabe 9/2014

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Abstract

Introduction and hypothesis

This study’s aims were to detect and quantify bacterial DNA in the urine of randomized trial participants about to undergo treatment for urinary urgency incontinence (UUI) without clinical evidence of urinary tract infection (UTI) and to determine if the presence of bacterial DNA in baseline urine relates to either baseline urinary symptoms or UTI risk after urinary tract instrumentation.

Methods

Women without clinical evidence of baseline UTI were randomized to cystoscopic onabotulinum toxin A injection and oral placebo medication versus cystoscopic placebo injection and active oral medication. Bacterial DNA in participants’ catheterized urine was measured by quantitative polymerase chain reaction (qPCR).

Results

Bacterial DNA was detected in the urine of 38.7 % of participants (60 out of 155). In these 60 qPCR-positive participants, baseline daily UUI episodes were greater than in the 95 qPCR-negative participants (5.71 [±2.60] vs 4.72 [±2.86], p = 0.004). Neither symptom severity by questionnaire nor treatment outcome was associated with qPCR status or with qPCR level in qPCR-positive subjects. In contrast, the presence of urinary bacterial DNA was associated with UTI risk: only 10 % of the qPCR-positive women developed a UTI post-treatment, while 24 % of the qPCR-negative women did so. The median qPCR level for qPCR-positive samples did not differ significantly by UTI status (UTI 2.58 × 105 vs no UTI 1.35 × 105 copies/mL, p = 0.6).

Conclusions

These results may indicate a urinary bacterial contribution to both baseline UUI and the risk of post-treatment UTI.
Literatur
1.
Zurück zum Zitat Albo ME, Richter H, Brubaker L, Norton P, Kraus SR, Zimmern PE et al (2007) Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 356(21):2143–2155PubMedCrossRef Albo ME, Richter H, Brubaker L, Norton P, Kraus SR, Zimmern PE et al (2007) Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 356(21):2143–2155PubMedCrossRef
2.
Zurück zum Zitat Richter HE, Albo ME, Zyczynski HM, Kenton K, Norton PA, Sirls LT et al (2010) Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med 362(22):2066–2076PubMedCentralPubMedCrossRef Richter HE, Albo ME, Zyczynski HM, Kenton K, Norton PA, Sirls LT et al (2010) Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med 362(22):2066–2076PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Wolfe AJ, Toh E, Shibata N, Rong R, Kenton K, Fitzgerald M et al (2012) Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol 50(4):1376–1383PubMedCentralPubMedCrossRef Wolfe AJ, Toh E, Shibata N, Rong R, Kenton K, Fitzgerald M et al (2012) Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol 50(4):1376–1383PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Siddiqui H, Nederbragt AJ, Lagesen K, Jeansson SL, Jakobsen KS (2011) Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol 11(1):244PubMedCentralPubMedCrossRef Siddiqui H, Nederbragt AJ, Lagesen K, Jeansson SL, Jakobsen KS (2011) Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol 11(1):244PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Fouts D, Pieper R, Szpakowski S, Pohl H, Knoblach S, Suh M et al (2012) Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 10(1):174PubMedCentralPubMedCrossRef Fouts D, Pieper R, Szpakowski S, Pohl H, Knoblach S, Suh M et al (2012) Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med 10(1):174PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Khasriya R, Sathiananthamoorthy S, Ismail S, Kelsey M, Wilson M, Rohn JL et al (2013) Spectrum of bacterial colonization associated with urothelial cells from patients with chronic lower urinary tract symptoms. J Clin Microbiol 51(7):2054–2062PubMedCentralPubMedCrossRef Khasriya R, Sathiananthamoorthy S, Ismail S, Kelsey M, Wilson M, Rohn JL et al (2013) Spectrum of bacterial colonization associated with urothelial cells from patients with chronic lower urinary tract symptoms. J Clin Microbiol 51(7):2054–2062PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Visco AG, Brubaker L, Richter HE, Nygaard I, Paraiso MF, Menefee SA et al (2012) Anticholinergic versus botulinum toxin A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial. Contemp Clin Trials 33(1):184–196PubMedCentralPubMedCrossRef Visco AG, Brubaker L, Richter HE, Nygaard I, Paraiso MF, Menefee SA et al (2012) Anticholinergic versus botulinum toxin A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial. Contemp Clin Trials 33(1):184–196PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Visco AG, Brubaker L, Richter HE, Nygaard I, Paraiso MFR, Menefee SA et al (2012) Anticholinergic therapy vs OnabotulinumtoxinA for urgency urinary incontinence. N Engl J Med 367:1803–1813PubMedCentralPubMedCrossRef Visco AG, Brubaker L, Richter HE, Nygaard I, Paraiso MFR, Menefee SA et al (2012) Anticholinergic therapy vs OnabotulinumtoxinA for urgency urinary incontinence. N Engl J Med 367:1803–1813PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Sanford JP, Favour CB, Mao FH, Harrison JH (1956) Evaluation of the positive urine culture; an approach to the differentiation of significant bacteria from contaminants. Am J Med 20(1):88–93PubMedCrossRef Sanford JP, Favour CB, Mao FH, Harrison JH (1956) Evaluation of the positive urine culture; an approach to the differentiation of significant bacteria from contaminants. Am J Med 20(1):88–93PubMedCrossRef
10.
Zurück zum Zitat Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG et al (2011) International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 52(5):e103–e120PubMedCrossRef Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG et al (2011) International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 52(5):e103–e120PubMedCrossRef
11.
Zurück zum Zitat Oliver JD (2005) The viable but nonculturable state in bacteria. J Microbiol 43(Spec No):93–100PubMed Oliver JD (2005) The viable but nonculturable state in bacteria. J Microbiol 43(Spec No):93–100PubMed
12.
Zurück zum Zitat Zoetendal EG, Vaughan EE, de Vos WM (2006) A microbial world within us. Mol Microbiol 59(6):1639–1650PubMedCrossRef Zoetendal EG, Vaughan EE, de Vos WM (2006) A microbial world within us. Mol Microbiol 59(6):1639–1650PubMedCrossRef
13.
Zurück zum Zitat Human Microbiome Consortium (2012) Structure, function and diversity of the healthy human microbiome. Nature 7402(486):207–214 Human Microbiome Consortium (2012) Structure, function and diversity of the healthy human microbiome. Nature 7402(486):207–214
14.
Zurück zum Zitat Costello EK, Lauber CL, Hamady M, Fierer N, Gordon JI, Knight R (2009) Bacterial community variation in human body habitats across space and time. Science 326(5960):1694–1697PubMedCentralPubMedCrossRef Costello EK, Lauber CL, Hamady M, Fierer N, Gordon JI, Knight R (2009) Bacterial community variation in human body habitats across space and time. Science 326(5960):1694–1697PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Margulies M, Egholm M, Altman WE, Attiya S, Bader JS, Bemben LA et al (2005) Genome sequencing in microfabricated high-density picolitre reactors. Nature 437(7057):376–380PubMedCentralPubMed Margulies M, Egholm M, Altman WE, Attiya S, Bader JS, Bemben LA et al (2005) Genome sequencing in microfabricated high-density picolitre reactors. Nature 437(7057):376–380PubMedCentralPubMed
16.
Zurück zum Zitat Shendure J, Porreca GJ, Reppas NB, Lin X, McCutcheon JP, Rosenbaum AM et al (2005) Accurate multiplex polony sequencing of an evolved bacterial genome. Science 309(5741):1728–1732PubMedCrossRef Shendure J, Porreca GJ, Reppas NB, Lin X, McCutcheon JP, Rosenbaum AM et al (2005) Accurate multiplex polony sequencing of an evolved bacterial genome. Science 309(5741):1728–1732PubMedCrossRef
17.
Zurück zum Zitat Bentley DR, Balasubramanian S, Swerdlow HP, Smith GP, Milton J, Brown CG et al (2008) Accurate whole human genome sequencing using reversible terminator chemistry. Nature 456(7218):53–59PubMedCentralPubMedCrossRef Bentley DR, Balasubramanian S, Swerdlow HP, Smith GP, Milton J, Brown CG et al (2008) Accurate whole human genome sequencing using reversible terminator chemistry. Nature 456(7218):53–59PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat McKernan KJ, Peckham HE, Costa GL, McLaughlin SF, Fu Y, Tsung EF et al (2009) Sequence and structural variation in a human genome uncovered by short-read, massively parallel ligation sequencing using two-base encoding. Genome Res 19(9):1527–1541PubMedCentralPubMedCrossRef McKernan KJ, Peckham HE, Costa GL, McLaughlin SF, Fu Y, Tsung EF et al (2009) Sequence and structural variation in a human genome uncovered by short-read, massively parallel ligation sequencing using two-base encoding. Genome Res 19(9):1527–1541PubMedCentralPubMedCrossRef
19.
Zurück zum Zitat Drmanac R, Sparks AB, Callow MJ, Halpern AL, Burns NL, Kermani BG et al (2010) Human genome sequencing using unchained base reads on self-assembling DNA nanoarrays. Science 327(5961):78–81PubMedCrossRef Drmanac R, Sparks AB, Callow MJ, Halpern AL, Burns NL, Kermani BG et al (2010) Human genome sequencing using unchained base reads on self-assembling DNA nanoarrays. Science 327(5961):78–81PubMedCrossRef
20.
Zurück zum Zitat Nelson DE, Van Der Pol B, Dong Q, Revanna KV, Fan B, Easwaran S et al (2010) Characteristic male urine microbiomes associate with asymptomatic sexually transmitted infection. PLoS One 5(11):e14116PubMedCentralPubMedCrossRef Nelson DE, Van Der Pol B, Dong Q, Revanna KV, Fan B, Easwaran S et al (2010) Characteristic male urine microbiomes associate with asymptomatic sexually transmitted infection. PLoS One 5(11):e14116PubMedCentralPubMedCrossRef
Metadaten
Titel
Urinary bacteria in adult women with urgency urinary incontinence
verfasst von
Linda Brubaker
Charles W. Nager
Holly E. Richter
Anthony Visco
Ingrid Nygaard
Matthew D. Barber
Joseph Schaffer
Susan Meikle
Dennis Wallace
Noriko Shibata
Alan J. Wolfe
Publikationsdatum
01.09.2014
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 9/2014
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2325-2

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