Urinary microbiome may differ in women with urge incontinence

New research by microbiologists at Loyola University suggests that the urinary microbiome in women with urgency urinary incontinence (UUI) may differ from that in women without the condition, which has implications for management of the disease.

Published in mBio, the journal of the American Society of Microbiology, the findings were based on comparison of bacterial DNA and culture of urine samples from 100 women with UUI and 100 without UUI. Between August 2012 and February 2014, the patients were recruited from the Female Pelvic Medicine and Reconstructive Surgery Center of Loyola University Medical Center. Exclusion criteria included a current history of urinary tract infection (UTI), a history of recurrent UTI, and antibiotic exposure in the past 4 weeks for any reason.

Transurethral catheterization was used to collect urine, which was analyzed using 16S rRNA gene sequencing and cultured. Using both techniques, the researchers found significant differences in the urinary microbiome of women with and without UUI. Garnerella was increased and Lactobacillus was decreased in the women with UUI and nine genera-Actinobaculum, Actinomyces, Aerococcus, Arthrobacter, Corynebacterium, Gardnerella, Oligella, Staphylococcus, and Streptococcus-were more frequently cultured in their urine. In the UUI cohort, Latobacillus gasseri was detected more frequently, whereas in the women without UUI, Lactobacillus crispatus was seen more often.

The authors noted that the cohort with UUI had a higher body mass index (32 versus 28; P=0.01), was more likely to be using estrogen (27% versus 61%; P<0.05) and was older (63 versus 49; P<0.05) than the cohort without UUI. They were not able to say, however, how those differences might have affected their findings. The researchers theorized that “the UUI bladder selects for some bacteria over others, and as such, the presence of these organisms [Actinomyces, Aerococcus, and Gardnerella] could serve as a marker for dysbiosis.”

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