IUGA Meeting 2023 - Basic Science Session - Contemporary Directions in UTI Research

Harry Horsley moderated an excellent Basic Science Session. UTI is one of the most common diagnoses, and it is a great burden to the health care system. In this regard, it is important to cure and prevent UTIs. Current research has shown us that standard culture methods do not provide us with enough data. In UTI patients, we may choose other treatment options to prevent antibiotic resistance.  Even when we do not use antibiotics, 23% of the patients are cured. The microbiome studies so far have given us an opportunity to better understand the etiology of most diseases and to do better algorithms. Urine has been proven not to be sterile, and some microbes like Lactobacillus are shown to be related to urinary health. The interactions between vaginal, intestinal, and urinary microbiomes are also being researched. However, there are lots of arguments about the methodology of this research. It is not clear which method is to be used in these studies. The taxonomy levels researched should be more profound than the strain levels, according to some researchers. However, it is expensive and time-consuming to achieve that kind of deeper investigation. And the clinical use of this kind of deeper knowledge is not known yet. The relationship between the microbiome and the diseases is not defined. Moreover, the immune response also needs to be considered. The pathogenesis of recurrent UTIs is connected to the inadequate response of the immune system. This response is helpful to limit infection and not harm the uroepithelium during the infection. But it happens at the cost of not having a memory of the host’s immune response. Despite its flawed use, the simple urine test is not expected to be replaced with another technique in the near future. So, clinicians should be aware of its limitations. Also, killing the pathogen option should be replaced by building a healthy ecosystem.