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Anglim B, Phillips C, Shynlova O, et al. The effect of local estrogen therapy on the urinary microbiome composition of postmenopausal women with and without recurrent urinary tract infections. Int Urogynecol J. 2021;doi: 10.1007/s00192-021-04832-9.
Anglim, B., Phillips, C., Shynlova, O., & Alarab, M. (2021). The effect of local estrogen therapy on the urinary microbiome composition of postmenopausal women with and without recurrent urinary tract infections. International urogynecology journal, . https://doi.org/10.1007/s00192-021-04832-9
Anglim, Breffini, et al. "The effect of local estrogen therapy on the urinary microbiome composition of postmenopausal women with and without recurrent urinary tract infections." International urogynecology journal vol. (2021). doi: https://doi.org/10.1007/s00192-021-04832-9
Anglim B, Phillips C, Shynlova O, Alarab M. The effect of local estrogen therapy on the urinary microbiome composition of postmenopausal women with and without recurrent urinary tract infections. Int Urogynecol J. 2021 May 18; doi: 10.1007/s00192-021-04832-9. Epub 2021 May 18. PMID: 34003309.
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Int Urogynecol J. 2021 May 18; doi: 10.1007/s00192-021-04832-9. Epub 2021 May 18.

The effect of local estrogen therapy on the urinary microbiome composition of postmenopausal women with and without recurrent urinary tract infections.

International urogynecology journal

Breffini Anglim, Caleb Phillips, Oksana Shynlova, May Alarab

Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada. [email protected].
  2. Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA.
  3. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, M5G 1X5, Canada.
  4. Lunenfeld-Tanenbaum Research Institute at Sinai Health System, Toronto, ON, Canada.

PMID: 34003309 DOI: 10.1007/s00192-021-04832-9

Abstract

INTRODUCTION AND HYPOTHESIS: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

Keywords: Finegoldia magna; Local estrogen therapy; Recurrent urinary tract infections; Urinary microbiome

References

  1. Sturdee D, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13(6):509–22. - PubMed
  2. Nygaard I, Johnson J. Urinary tract infection in elderly women. Am Fam Phys. 1996;53(1):175–82. - PubMed
  3. 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. - PubMed
  4. 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. - PubMed
  5. Brubaker L, Wolfe A. The new world of the urinary microbiota in women. Am J Obstet Gynecol. 2015;213(5):644–9. - PubMed
  6. 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. - PubMed
  7. Stamm W. Estrogens and urinary-tract infection. J Infect Dis. 2007;195:623–4. - PubMed
  8. 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. - PubMed
  9. 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. - PubMed
  10. 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. - PubMed
  11. 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. - PubMed
  12. The Human Microbiome Project Consortium. A framework for human microbiome research. Nature. 2012;486:215–21. - PubMed
  13. Edgar R. Search and clustering orders of magnitude faster than BLAST. Bioinformatics. 2010;26(19):2460–1. - PubMed
  14. Edgar R. UPARSE: highly accurate OTU sequences from microbial amplicon reads. Nat Methods. 2013;10:996–8. - PubMed
  15. 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. - PubMed
  16. Benson D, Karsch-Mizrachi I, Lipman D, Ostell J, Sayers Z. Genbank. Nucl Acid Res. 2009;37(1):d26–31. - PubMed
  17. 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. - PubMed
  18. 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. - PubMed
  19. 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. - PubMed
  20. 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. - PubMed
  21. Murdoch D. Gram-positive Anaerobic cocci. Clin Microbiol Rev. 1998;11(1):81–120. - PubMed
  22. Stapleton A. The vaginal microbiota and urinary tract infection. Microbiol Spectr. 2016;4(6):10. - PubMed
  23. 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. - PubMed
  24. Chart H. Klebsiella, enterobacter, proteus and other enterobacteria: Pneumonia; urinary tract infection; opportunist infection. Med Microbiol (Eighteenth Edition). 2012;290–7. - PubMed
  25. Stamm W, McKevitt M, Roberts P, White N. Natural history of recurrent urinary tract infections in women. Rev Infect Dis. 1991;13:77–84. - PubMed
  26. Oelschlaeger T, Tall B. Invasion of cultured human epithelial cells by Klebsiella pneumoniaeisolated from the urinary tract. Infect Immun. 1997;65:2950–8. - PubMed
  27. Shank E, Kolter R. New developments in microbial interspecies signaling. Curr Opin Microbiol. 2009;12(2):205–14. - PubMed
  28. 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. - PubMed
  29. 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. - PubMed
  30. Cleary M, Grossmann M. Minireview: obesity and breast cancer: the estrogen connection. Endocrinol. 2009;150(6):2537–42. - PubMed

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