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    Dr. Andrei Manu-Marin: Medic Primar Urolog Specializare În Neuro-Urologie

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    KINETO62
    This document discusses the urinary microbiota and its role in urinary tract conditions. It summarizes research showing differences in the urinary microbiota between incontinent and continent women. Key bacteria identified include Lactobacillus species and E. coli. The document also discusses using expanded urine culture techniques to better identify resident bacteria. It provides perspectives on using asymptomatic bacteria and Lactobacillus to modulate pain and treat recurrent infections and overactive bladder. The importance of not treating asymptomatic bacteriuria with antibiotics to preserve the urinary microbiota is also noted.

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    Dr. Andrei Manu-Marin: Medic Primar Urolog Specializare În Neuro-Urologie

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    KINETO62
    40 views12 pages
    This document discusses the urinary microbiota and its role in urinary tract conditions. It summarizes research showing differences in the urinary microbiota between incontinent and continent women. Key bacteria identified include Lactobacillus species and E. coli. The document also discusses using expanded urine culture techniques to better identify resident bacteria. It provides perspectives on using asymptomatic bacteria and Lactobacillus to modulate pain and treat recurrent infections and overactive bladder. The importance of not treating asymptomatic bacteriuria with antibiotics to preserve the urinary microbiota is also noted.

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    Microbiota urinară

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    Microbiota urinară

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    This document discusses the urinary microbiota and its role in urinary tract conditions. It summarizes research showing differences in the urinary microbiota between incontinent and continent women. Key bacteria identified include Lactobacillus species and E. coli. The document also discusses using expanded urine culture techniques to better identify resident bacteria. It provides perspectives on using asymptomatic bacteria and Lactobacillus to modulate pain and treat recurrent infections and overactive bladder. The importance of not treating asymptomatic bacteriuria with antibiotics to preserve the urinary microbiota is also noted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    40 views12 pages

    Dr. Andrei Manu-Marin: Medic Primar Urolog Specializare În Neuro-Urologie

    Uploaded by

    KINETO62
    This document discusses the urinary microbiota and its role in urinary tract conditions. It summarizes research showing differences in the urinary microbiota between incontinent and continent women. Key bacteria identified include Lactobacillus species and E. coli. The document also discusses using expanded urine culture techniques to better identify resident bacteria. It provides perspectives on using asymptomatic bacteria and Lactobacillus to modulate pain and treat recurrent infections and overactive bladder. The importance of not treating asymptomatic bacteriuria with antibiotics to preserve the urinary microbiota is also noted.

    Copyright:

    © All Rights Reserved
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    of 12

    Dr.

    Andrei Manu-Marin
    Medic primar urolog
    Specializare în neuro-urologie
    MICROBIOTA
    URINARA

    ANDREI MANU-MARIN
    EVOMED
    MICROBIOTA / MICROBIOM

     “microbiota” (the microbes themselves)


     “microbiome” (the genetic material of those microbes)
     MICROBIOM – US-NIH – proiect lansat in 2007
     Gut Microbiota – rol in – afectiuni psihice, cardio-vasculare, metabolismul osos, imunitate/HIV, alergie
     Microbiota–Gut–Brain Axis – Neufeld KM, NeuroGastroenterol Motil 23.255-264 (2011) starea psihica+comportament
     UROBIOM – lansat in 2012
     Urobiota – este diferita la femeile cu incontinenta si la cele cu dureri vezicale cronice.
    MICROBIOTA –
    FEMEI

    CONTINENTE
    (NON-UUI)

    VS

    INCONTINENTE
    Thomas-White KJ, Hilt EE, Fok C, Pearce MM, Mueller ER, Kliethermes S, Jacobs K, (UUI)
    Zilliox, MJ, Brincat C, Price TK, et al. Incontinence medication response relates to the
    female urinary microbiota. Int Urogynecol J. 2015
     MICROBIOTA SPECII
    BACTERIENE

    FEMEI INCONTINENTE
    FEMALE URINARY MICROBIOTA (FUM)

     Menopausal women not on exogenous hormones had increased microbial diversity and their FUM was less likely
    to be predominated by a single microbe.
     A similar relationship was observed between microbial diversity and UUI symptoms.
     These results suggest that predominance (most often by Lactobacillus species) is typical of hormone-positive
    women and that loss of that predominance might be associated with UUI symptoms
     Intriguingly, while Lactobacillus crispatus in the FUM was associated with the non-symptomatic controls,
    Lactobacillus gasseri in the FUM was associated with UUI.

    • Curr Opin Obstet Gynecol. 2016 October ; 28(5): 407–412. doi:10.1097/GCO.0000000000000298. MS1. Linda Brubaker, MD, and Alan Wolfe
    • Pearce MM, Hilt EE, Rosenfeld AB, Zilliox MJ, Thomas-White K, Fok C, Kliethermes S, Schreckenberger PC, Brubaker L, Gai X, et al. The female
    urinary microbiome: a comparison of women with and without urgency urinary incontinence. MBio. 2014; 5:e01283–01214
    EXPANDED QUANTITATIVE URINE CULTURE (EQUC)

     Each catheterized urine sample was processed following the standard urine culture procedure by the clinical
    microbiology lab and then was processed using the EQUC procedure.
     For EQUC, 0.1 ml of urine was inoculated onto BAP (sheep Blood Agar Plate), chocolate and colistin, and
    nalidixic acid (CNA) agars (BD BBL prepared plated media - Becton, Dickinson and Co., Sparks, MD), streaked for
    quantitation, and incubated in 5% CO2 at 35°C for 48 h.
     For UTI diagnosis, each uropathogen may have its own unique threshold (e.g., 102 CFU/ml for Aerococcus
    urinae, 103 CFU/ml for Streptococcus agalactiae, and 104 CFU/ml for Klebsiella pneumoniae).

    Urine Is Not Sterile: Use of Enhanced Urine Culture Techniques To Detect Resident Bacterial Flora in the Adult Female Bladder.
    Evann E. Hilt, Kathleen McKinley, Meghan M. Pearce, Amy B. Rosenfeld, Michael J. Zilliox, Elizabeth R. Mueller, Linda Brubaker, Xiaowu Gai, Alan J. Wolfe, Paul
    C.Schreckenbergera. March 2014 Volume 52 Number 3 Journal of Clinical Microbiology p. 871–876
    MICROBIOTA IN CISTITA ACUTA

    Average CFU per milliliter of uropathogens


    between the UTI and no-UTI cohorts.

    Depicted are the average CFU per milliliter with


    which the various uropathogens were cultured
    for both cohorts: UTI (blue bars) and no-UTI (red
    bars).
     Average CFU of Klebsiella pneumoniae (P 0.04)
    and Streptococcus agalactiae (P0.02) are
    significantly higher in the UTI cohort (*).
    Several uropathogens had substantially lower
    average CFU-per-milliliter values in the no-UTI
    cohort than in the UTI cohort: Aerococcus urinae
    (P 0.12), Enterococcus faecalis (P 0.09), Escherichia
    coli (P 0.08), Staphylococcus aureus (P 0.06), and
    Streptococcus anginosus (P 0.06). Independent t
    test (*, P 0.05).
    The Clinical Urine Culture: Enhanced Techniques Improve Detection of  Black bars depict common UTI thresholds.
    Clinically Relevant Microorganisms. Travis K. Price, Tanaka Dune, Evann E. Hilt, Krystal J.
    Thomas-White, Stephanie Kliethermes, Cynthia Brincat, Linda Brubaker, Alan J. Wolfe, Elizabeth R.
    Mueller, Paul C. Schreckenbergere.
    Journal of Clinical Microbiology May 2016 Volume 54 Number 5
    LACTOBACILLUS

     Czaja CA, Stapleton AE,Yarova-Yarovaya Y, Stamm WE (2007) Phase I trial of a Lactobacillus crispatus vaginal
    suppository for prevention of recurrent urinary tract infection in women. Infect Dis Obstet Gynecol 2007: 35387.
     Certain Lactobacillus species that colonize the vagina excrete lactic acid and hydrogen peroxide, inhibiting the
    growth of uropathogenic E coli.
    E. COLI UROPATOGEN (UPEC)

     UTI pain was due to E. coli lipopolysaccharide (LPS) and its receptor, TLR4, but pain was not correlated with
    inflammation.
     Inflammatory responses in wild type mice were similar among E. coli strains spanning a wide range of pain
    phenotypes, suggesting that O-antigen modulates pain independent of inflammation.
     A UPEC mutant defective for O-antigen biosynthesis induced chronic allodynia that persisted long after
    clearance of transient infections,
     Wild type UPEC evoked only acute pain.
     Chronic allodynia was abrogated in TLR4-deficient mice.

    Rudick CN, Jiang M,Yaggie RE, Pavlov VI, Done J, et al. (2012) O-Antigen Modulates Infection-Induced Pain States. PLoS ONE 7(8):
    e41273. doi:10.1371/journal.pone.0041273
    E. COLI ASIMPTOMATIC (ASB)

     ASB E. coli (83972) were similarly effective against UTI allodynia induced by Proteus mirabilis, Enterococccus
    faecalis and Klebsiella pneumoniae. Therefore, ASB E. coli have anti-infective activity comparable to the current
    standard of care yet also provide superior analgesia. (1)
     ASB E. coli 2-12 - No LUTS were noted in any of the 6 research dogs after ASB E. coli 2-12 infusion. Four of the
    nine client-owned dogs had complete or nearly complete clinical cures by day 14. Of these four dogs, 3 also had
    microbiologic cures at day 14; one of these dogs had subclinical bacteriuria (in addition to ASB E. coli 2-12). Three
    of these four dogs had ASB E. coli 2-12 isolated from their urine at day 14.

    1. Rudick CN,Taylor AK,Yaggie RE, Schaeffer AJ, Klumpp DJ (2014) Asymptomatic Bacteriuria Escherichia coli Are Live
    Biotherapeutics for UTI. PLoS ONE 9(11): e109321. doi:10.1371/journal.pone.0109321
    2. Evaluation of the Live Biotherapeutic Product, Asymptomatic Bacteriuria Escherichia coli 2-12, in Healthy Dogs and Dogs with
    Clinical Recurrent UTI. G. Segev , J.E. Sykes, D.J. Klumpp, A.J. Schaeffer, E.M. Antaki, B.A. Byrne, R.E.Yaggie, and J.L. Westropp. J
    Vet Intern Med 2018;32:267–273
    PERSPECTIVE CLINICE

     E. coli asimptomatic
     Lactobacil
     Modularea durerii in cistita recidivanta
     Vezica hiperactiva rezistenta la tratament
     Flora vaginala- estrogenizare
     Bacteriuria asimptomatica NU se trateaza antibiotic = UROBIOTA

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