Is there an association between vaginal, urethral and urinary microbiota in women with urogenital tract diseases?

Urinary tract infections (UTI), including recurrent cystitis, are usually interpreted in relation to dominant uropathogens. However, the microbial context of adjacent urogenital sites may also be relevant.
Aim. To evaluate the association between UTI and the microbiota of different parts of the urogenital tract in order to provide insights into disease pathogenesis and treatment. 
Material and methods. The study included three groups: healthy volunteer group (n= 34); patients at risk of developing UTI (women with micronephrolithiasis and/or bacterial vaginosis; n = 16); and patients with a history of recurrent lower UTI (n = 100). Four types of biomaterial were used: first-pass and midstream urine samples, urethral and vaginal swabs. All samples were analyzed by multiplex real-time polymerase chain reaction reagent kits Femoflor®16 and BacScreen OM.
Results. Genomic DNA and total bacterial quantities increased while relative lactobacilli decreased in patients with a risk of UTI and in those with recurrent lower UTI. This was only the case in midstream and first-pass urine samples. Relative lactobacilli levels in the urethral and vaginal swabs were only slightly but statistically significantly reduced in patients with recurrent lower UTI. Facultative anaerobes predominated in urine samples of patients with a risk of UTI, while in patients with recurrent lower UTI an increase in both facultative and obligate anaerobes was observed.
Conclusion. Midstream and first-pass urine samples can reliably assess inflammation in the urogenital tract. No strict correlation was observed between the vaginal and urinary microbiota of patients with recurrent lower UTI, meaning that UTI do not necessarily affect the vaginal biotope.

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