Urinary Microbiota and Risk of Postsurgical UTI

Certain urinary bacteria and antimicrobial peptides could help identify women with an increased risk of urinary tract infection (UTI) following pelvic floor surgery.

Researchers from Loyola University Chicago Stritch School of Medicine found significant differences in the day of surgery urinary microbiota of women in whom a postoperative UTI developed compared with women who did not have a UTI develop. The study consisted of 54 women and was published in PLOS One.

Pertinent Point:

- By analyzing the urinary bacteria and antimicrobial peptides of women who are about to undergo pelvic floor surgery, researchers hope to identify those who are at increased risk for the development of a postsurgical UTI.

The differences could help doctors improve UTI prevention by evaluating urine samples on the day of surgery, the researchers suggested, adding that any such test is not yet ready for clinical practice.

Of the participants, 10 women, or 18.5%, developed UTI symptoms after surgery and four, or 7%, had positive urine cultures post surgery. When researchers analyzed the cultures, they found UTI risk significantly correlated with both specific urinary microbiota and β-defensin antimicrobial peptide (AMP) levels. In addition, urinary AMP hydrophobicity (an absence of attraction) and protease activity were greater in participants in whom a UTI developed. Finally, lower risk of postoperative UTI correlated with greater bacterial diversity, greater abundance of the Lactobacillus species, and higher levels of the antimicrobial peptide β-defensin-1.

The data collected during the study suggest there is a link between urinary microbiota, AMP responses, and symptoms that could help pinpoint a biomarker for UTI risk, the researchers concluded.