Discovery of bladder ‘mini-microbiome’ signals UTI treatment change

Cutting edge genomics has now shown the female bladder is home to a community of bacteria – similar to the gut microbiome – even in the absence of infection.

Dr Sam Forster - New urinary tract infection research has shown that the female bladder is home to a community of bacteria or mini-microbiome.
Dr Sam Forster

A team of microbiologists and genomics experts from the Wellcome Sanger Institute (Cambridge, UK), Loyola University Chicago (USA) and Hudson Institute of Medical Research (Melbourne, Australia) made the discovery.

The findings of the study have been published in the journal Nature Communications.

“The female bladder has long been considered sterile except in women with urinary tract infections,” Dr Samuel Forster, joint-first author and research group head at Hudson Institute of Medical Research, says.

“Now, medical genomics is superseding over 100 years of medical dogma by showing bacteria associated with health in the female reproductive tract are also able to colonise the bladder without causing clinical infection.”

In a first, the team isolated and genome-sequenced 149 strains of bacteria found in urine samples from 77 healthy and symptomatic pre-menopausal women, then grew them in the laboratory to create a ‘living library’ of bacteria outside of the human body.

Bad or good bacteria? Depends on the environment

Dr Forster says the research could provide new treatment approaches for urinary tract infections and urinary incontinence, which account for one to two per cent of all GP consultations.

More than 70,000 people are hospitalised with kidney and urinary tract infections in Australia each year, and antibiotics are the most common form of treatment.

“This research completely redefines the way we think about bacteria in the bladder and female reproductive tract. It has the potential to fundamentally change the way we treat urinary tract infections and diseases,” Dr Forster says.

“This knowledge also raises the question – if antibiotics are used to kill the ‘bad’ bacteria in patients with urinary tract infections, could this also upset the balance of healthy bacteria that have a protective effect – much like in the gut?

“While the bacteria in this bladder ‘mini-microbiome’ are much lower in numbers and diversity than the gut microbiome, it still gives us important clues about health and disease.

Dr Samuel Forster was generously supported by the National Health and Medical Research Council (NHMRC) CJ Martin Biomedical Fellowship: 1091097

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