Assessment of the Lower Urinary Tract Microbiota during Symptom Flare in Women with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study

We compared culture-independent assessment of microbiota of the lower urinary tract in standard culture negative female UCPPS patients who reported symptom flare to those who did not report a flare.

Initial stream (VB1) and midstream (VB2) urine specimens (n=233 UCPPS patients) were analyzed with Ibis T-5000 Universal Biosensor system technology for comprehensive identification of microorganism species. Differences between flare and non-flare groups for presence or number of different species within a higher level group (richness) were examined by permutational multivariate analysis of variance and logistic regression.

Overall, 81 species (35 genera) were detected in VB1 and 73 (33) in VB2. Mean (SD) VB1 and VB2 species count per person was 2. 6 (1. 5) and 2. 4 (1. 5) for 86 flare patients and 2. 8 (1. 3) and 2. 5 (1. 5) for 127 non-flare patients, respectively. Overall, species composition did not significantly differ between flare and non-flare patients at any level (p=0. 14 species, p=0. 95, genus in VB1 and VB2, respectively) in multivariate analysis for richness. Univariate analysis, both unadjusted and adjusted, confirmed significantly greater prevalence of fungi (Candida and Saccharomyces) in flare group (15. 7%) compared to non-flare group in VB2 (3. 9%) (p=0. 01). When adjusted for antibiotic use and menstrual phase, women who reported a flare remained more likely to have fungi present in VB2 specimens [OR= 8. 3, CI=1. 7-39. 4)].

Among women with UCPPS the prevalence of fungi (Candida and Saccharomyces sp. ) was significantly greater in those who reported a flare compared to those who did not.

The Journal of urology. 2015 Sep 24 [Epub ahead of print]

J Curtis Nickel, Alisa Stephens, J Richard Landis, Chris Mullins, Adrie van Bokhoven, M Scott Lucia, Garth D Ehrlich, MAPP Research Network

Department of Urology, Queen's University, Kingston, Ontario, Canada. Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. , Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. , National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. , Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO. , Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO. , Departments of Microbiology & Immunology and Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA.

PubMed

Pelvic Health Weekly Newsletter