The effect of local estrogen therapy on the urinary microbiome composition of postmenopausal women with and without recurrent urinary tract infections.
Finegoldia magna
Local estrogen therapy
Recurrent urinary tract infections
Urinary microbiome
Journal
International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
16
02
2021
accepted:
26
04
2021
pubmed:
19
5
2021
medline:
4
8
2022
entrez:
18
5
2021
Statut:
ppublish
Résumé
Recurrent urinary tract infections (rUTIs) occur in 2-10% of postmenopausal women. Local estrogen therapy (LET) has been shown to reduce UTIs. This study aimed to compare the urinary microbiome between patients with and without a history of rUTIs and to examine whether treatment with LET influences the diversity and richness of microbiome species in two groups. Postmenopausal women with and without rUTIs attending the urogynecology clinic between April 2019 and December 2020 were recruited. Participant baseline characteristics and demographics were recorded. Aseptic transurethral urine samples were collected at recruitment and at 3-6 months following treatment with LET. The V1-V2 and ITS regions of the 16S rRNA gene were sequenced to identify bacteria. A total of 37 women were recruited, 20 controls and 17 patients with rUTI. During follow-up, symptomatic UTIs occurred in 3/17 (17.6%) and 0/20 in the rUTI group and control group, respectively. Klebsiella aerogenes was present in 80% of rUTI samples and in 53.3% of control samples before LET. Abundance of Finegoldia magna was present in 33.3% of samples before LET, but only in 6.7% after LET. There was no change in relative abundance of lactobacillus species following LET in both groups. Treatment with vaginal LET altered the local hormonal environment of the urinary bladder and likely protected women from development of rUTI by decreasing the presence of F. magna. To confirm the significance of this bacterial species in rUTI symptomatology, our finding needs to be validated on a larger patient cohort.
Identifiants
pubmed: 34003309
doi: 10.1007/s00192-021-04832-9
pii: 10.1007/s00192-021-04832-9
doi:
Substances chimiques
Estrogens
0
RNA, Ribosomal, 16S
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2107-2117Informations de copyright
© 2021. The International Urogynecological Association.
Références
Sturdee D, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13(6):509–22.
doi: 10.3109/13697137.2010.522875
Nygaard I, Johnson J. Urinary tract infection in elderly women. Am Fam Phys. 1996;53(1):175–82.
Hayden B, Freeman R, Lee J, Swift S, Cosson M. Deprest. standardization and terminology committees IUGA and ICS, joint IUGA/ICS working group on female terminology. Neurourol Urodyn. 2012;31(4):406–14.
doi: 10.1002/nau.22199
Wolfe A, Toh E, Shibata N, Rong R, Kenton K, FitzGerald M, et al. Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol. 2012;50(4):1376–83.
doi: 10.1128/JCM.05852-11
Brubaker L, Wolfe A. The new world of the urinary microbiota in women. Am J Obstet Gynecol. 2015;213(5):644–9.
doi: 10.1016/j.ajog.2015.05.032
Pearce M, Hilt E, Rosenfeld A, Zilliox M, Thomas-White K, Fok C. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. MBio. 2014;5(4):e01283–14.
doi: 10.1128/mBio.01283-14
Stamm W. Estrogens and urinary-tract infection. J Infect Dis. 2007;195:623–4.
doi: 10.1086/511526
Chen Y, Su T, Lau H. Estrogen for the prevention of recurrent urinary tract infections in postmenopausal women: a meta-analysis of randomized controlled trials. Int Urogynecol J. 2021;32:17–25.
doi: 10.1007/s00192-020-04397-z
Eriksen B. A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women. Am J Obstet Gynecol. 1999;180:1072–9.
doi: 10.1016/S0002-9378(99)70597-1
Shen J, Song N, William C, Brown C, Yan Z, Xu C. Effects of low dose estrogen therapy on the vaginal microbiomes of women with atrophic vaginitis. Sci Rep. 2016;6:24380.
doi: 10.1038/srep24380
Thomas-White K, Taege S, Limeira R, Brubaker L, Mueller E, Wolfe A. Vaginal estrogen therapy is associated with increased Lactobacillus in the urine of postmenopausal women with overactive bladder symptoms. Am J Obstet Gynecol. 2020;223(5):727 e1-727 e11.
doi: 10.1016/j.ajog.2020.08.006
The Human Microbiome Project Consortium. A framework for human microbiome research. Nature. 2012;486:215–21.
doi: 10.1038/nature11209
Edgar R. Search and clustering orders of magnitude faster than BLAST. Bioinformatics. 2010;26(19):2460–1.
doi: 10.1093/bioinformatics/btq461
Edgar R. UPARSE: highly accurate OTU sequences from microbial amplicon reads. Nat Methods. 2013;10:996–8.
doi: 10.1038/nmeth.2604
Sayers E, Barrett T, Benson D, Bryant S, Canese K, Chetvernin V, et al. Database resources of the national center for biotechnology information. Nucl Acid Res. 2016;4(44):D1 D7-19.
Benson D, Karsch-Mizrachi I, Lipman D, Ostell J, Sayers Z. Genbank. Nucl Acid Res. 2009;37(1):d26–31.
doi: 10.1093/nar/gkn723
Chen Z, Phan M, Bates L, Peters K, Mukerjee C, Moore K, et al. The urinary microbiome in patients with refractory urge incontinence and recurrent urinary tract infection. Int Urogynecol J. 2018;29(12):1775–82.
doi: 10.1007/s00192-018-3679-2
Fok C, Gao X, Lin H, Thomas-White K, Mueller E, Wolfe A, et al. Urinary symptoms are associated with certain urinary microbes in urogynecologic surgical patients. Int Urogynecol J. 2018;29(12):1765–71. https://doi.org/10.1007/s00192-018-3732-1 Int Urogynecol J. 2018;29(12):1765–71.
doi: 10.1007/s00192-018-3732-1
pubmed: 30116843
pmcid: 6830733
Wall I, Davies C, Hill K, Wilson M, Stephens P, Harding KG, et al. Potential role of anaerobic cocci in impaired human wound healing. Wound Repair Regen. 2002;10(6):346–53.
doi: 10.1046/j.1524-475X.2002.t01-1-10602.x
Brazier J, Chmelar D, Dubreuil L, Feierl G, Hedberg M, Kalenic S, et al. European surveillance study on antimicrobial susceptibility of grampositive anaerobic cocci. Int J Antimicrob Agents. 2008;31(4):316–20.
doi: 10.1016/j.ijantimicag.2007.11.006
Murdoch D. Gram-positive Anaerobic cocci. Clin Microbiol Rev. 1998;11(1):81–120.
doi: 10.1128/CMR.11.1.81
Stapleton A. The vaginal microbiota and urinary tract infection. Microbiol Spectr. 2016;4(6):10.
doi: 10.1128/microbiolspec.UTI-0025-2016
Doerflinger S, Throop A, Herbst-Kralovetz M. Bacteria in the vaginal microbiome alter the innate immune response and barrier properties of the human vaginal epithelia in a species-specific manner. J Infect Dis. 2014;209(12):1989–99.
doi: 10.1093/infdis/jiu004
Chart H. Klebsiella, enterobacter, proteus and other enterobacteria: Pneumonia; urinary tract infection; opportunist infection. Med Microbiol (Eighteenth Edition). 2012;290–7.
Stamm W, McKevitt M, Roberts P, White N. Natural history of recurrent urinary tract infections in women. Rev Infect Dis. 1991;13:77–84.
doi: 10.1093/clinids/13.1.77
Oelschlaeger T, Tall B. Invasion of cultured human epithelial cells by Klebsiella pneumoniaeisolated from the urinary tract. Infect Immun. 1997;65:2950–8.
doi: 10.1128/iai.65.7.2950-2958.1997
Shank E, Kolter R. New developments in microbial interspecies signaling. Curr Opin Microbiol. 2009;12(2):205–14.
doi: 10.1016/j.mib.2009.01.003
Thomas-White K, Hilt E, Fok C, Pearce M, Mueller E, Kliethermes S, et al. Incontinence medication response relates to the female urinary microbiota. Int Urogynecol J. 2016;27(5):723–33.
doi: 10.1007/s00192-015-2847-x
Wu P, Chen Y, Zhao J, Zhang G, Chen J, Wang J, et al. Urinary microbiome and psychological factors in women with overactive bladder. Front Cell Infect Microbiol. 2017;7:488.
doi: 10.3389/fcimb.2017.00488
Cleary M, Grossmann M. Minireview: obesity and breast cancer: the estrogen connection. Endocrinol. 2009;150(6):2537–42.
doi: 10.1210/en.2009-0070