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The microbiome of the urinary tract a role beyond infection
Samantha A. Whiteside, Hassan Razvi, Sumit Dave, Gregor Reid and Jeremy P. Burton
Abstract | Urologists rarely need to consider bacteria beyond their role in infectious disease. However, emerging evidence shows that the microorganisms inhabiting many sites of the body, including the urinary tractwhich has long been assumed sterile in healthy individualsmight have a role in maintaining urinaryhealth. Studies of the urinary microbiota have identified remarkable differences between healthy populations and those with urologic diseases. Microorganisms at sites distal to the kidney, bladder and urethra are likely to have a profound effect on urologic health, both positive and negative, owing to their metabolic output and other contributions. Connections between the gut microbiota and renal stone formation have already been discovered. In addition, bacteria are also used in the prevention of bladder cancer recurrence. In the future, urologists will need to consider possible influences of the microbiome in diagnosis and treatment of certain urological conditions. New insights might provide an opportunity to predict the risk of developing certainurological diseases and could enable the development of innovative therapeutic strategies.
Whiteside, S. A. etal. Nat. Rev. Urol. 12, 8190 (2015); published online 20 January 2015; http://www.nature.com/doifinder/10.1038/nrurol.2014.361
Web End =doi:10.1038/nrurol.2014.361
Introduction
The microbiota is defined as the microorganisms in a particular environment.1,2 More specifically, the term refers to the microbial taxa that are associated with an environment and are revealed using molecular techniques such as 16S ribosomal RNA (rRNA) sequencing. Conversely, the term microbiome is less firmly defined. Some groups limit the use of microbiome to the catalogue of microbes and their genes only,2 whereas our group and others prefer to refer to this as the metagenome (all genetic material of a population including plasmids). The term microbiome is used as a reference to the habitat as a whole,1 thus, incorporating the biotic and abiotic factors, encompassing host and microorganism genomes and environmental conditions (Figure1). The populations are composed of bacteria, archaea, viruses and fungi, which are predominantly found in the gastrointestinal tract, but also in other exposed tissues, such as the skin, upper respiratory and urogenital tracts.35
However, other tissues that were once considered sterile, such as the brain, breast, placenta and the urinary tract, also...