New research

Reassessment of routine midstream culture in diagnosis of urinary tract infection
Sanchutha Sathiananthamoorthy, James Malone-Lee, Kiren Gill, Anna Tymon, Trang K. Nguyen, Shradha Gurung, Linda Collins, Anthony S. Kupelian, Sheela Swamy, Rajvinder Khasriya, David A. Spratt, Jennifer L. Rohn – 2018

Midstream urine culture (MSU) are still widely seen as the gold standard diagnostic test for acute UTIs. But this research published in the Journal of Clinical Microbiology found that MSUs

  • miss a wide variety of bacteria
  • and can’t distinguish between infected patients from normal controls.

Cross over data supporting long term antibiotic treatment in patients with painful lower urinary tract symptoms, pyuria and negative urinalysis 2018

The paper published in the International Urogynecology Journal measured the effects of an unplanned and sudden end to treatment of patients with chronic UTI. Of a group of 221 patients

  • 199 patients reported a deterioration of their condition
  • 11 patients required hospital care.

Recalcitrant chronic bladder pain and recurrent cystitis but negative urinalysis: What should we do?
By Sheela Swamy, William Barcella, Maria De Iorio, Kiren Gill, Rajvinder Khasriya, Anthony S. Kupelian, Jennifer L. Rohn, James Malone-Lee. International Urogynecology Journal, March 2018

This research study looked at how lower urinary tract symptoms may be associated with chronic urinary tract infection undetected by routine diagnostic tests. Antimicrobial therapy might confer benefit for these patients.

A blinded observational cohort study of the microbiological ecology associated with pyuria and overactive bladder symptoms
Kiren Gill, Ryoon Kang, Sanchutha Sathiananthamoorthy, Rajvinder Khasriya, James Malone-Lee

This study supports the need to re-examine the OAB phenotype given this association with microbial colonisation.

Men only studies

The Prevalence and Overlap of Interstitial Cystitis/Bladder Pain Syndrome and Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men
RAND Interstitial Cystitis Epidemiology Male Study. The Journal of Urology, v. 189, no. 1, Jan. 2013, p. 141-145


Biofilms and Urinary Tract Infections (part 1)
By Nita Bishop, N.D. & Rowan Hamilton.

Biofilms and Urinary Tract Infections (part 2)
By Nita Bishop, N.D. & Rowan Hamilton.

Biofilms Made Easy.
By Phillips PL, Wolcott RD, Fletcher J & Schultz GS.

Diagnosing Treating Bacterial Biofilm Infections. Interview with Randy Wolcott by Richard Longland.
Filamentation by Escherichia coli subverts innate defenses during urinary tract infection.
By Sheryl S Justice, David A Hunted, Patrick C Seed & Scott J Hultgren.

Importance of Biofilms in Urinary Tract Infections: New Therapeutic Approaches
By Sara M. Soto.

Bacterial biofilms: development, dispersal, and therapeutic strategies in the dawn of the postantibiotic era.
Kostakioti M, Hadjifrangiskou M & Hultgren SJ.

Microbial Biofilms in Urinary Tract Infections and Prostatitis- Etiology, Pathogenicity, and Combating strategies
Cristina Delcaru, Ionela Alexandru, Paulina Podgoreanu, Mirela Grosu, Elisabeth Stavropoulos, Mariana Carmen Chifiriuc and Veronica Lazar 2016

Implication of biofilm formation in the persistence of urinary tract infection caused by uropathogenic Escherichia coli
S.M.Soto, A.Smithson, J.P.Horcajada, J.A.Martinez, J.P.Mensa, J.Vila 2006


Absolute and relative accuracy of rapid urine tests
Williams GJ1, Macaskill P, Chan SF, Turner RM, Hodson E, Craig JC

Diagnosis of urinary tract infection in children
Christopher D. Doernaand Susan E. Richardsonb

Prevalence of Asymptomatic Bacteriuria in Hospitalized Patients
Sergio E. Trevino, Jeffrey P. Henderson, Jiami Wu, Candice Cass, and Jonas Marschall

Clinical decision rule to identify febrile young girls at risk for urinary tract infection
Gorelick MH and Shaw KN

Low bacterial counts in infants with urinary tract infection
Hansson S, Brandström P, Jodal U, Larsson P

Pyuria and bacteriuria in urine specimens obtained by catheter from young children with fever
Hoberman A, Wald ER, Reynolds EA, Penchansky L, Charron M

Low bacterial count urinary tract infections in infants and young children
Theodoros A. KanellopoulosPaul J. VassilakosMarinos KantzisAikaterini EllinaFevronia KolonitsiouDimitris A. Papanastasiou

Diagnostic accuracy of urinary biomarkers in infants younger than 3 months with urinary tract infection
Nani Jung, Hye Jin Byun, MD, Jae Hyun Park, MD, Joon Sik Kim, MD, Hae Won Kim, MD, and Ji Yong Ha

Accuracy of clean-catch urine collection in infancy
Ramage IJ, Chapman JP, Hollman AS, Elabassi M, McColl JH, Beattie TJ

Urinary tract infection in infants: the significance of low bacterial count
Swerkersson S, Jodal U, Åhrén C, Sixt R, Stokland E, Hansson S

Use of rapid dipstick tests to exclude urinary tract infection in children
Sharief N, Hameed M, Petts D

Low urinary bacterial counts: do they count?
Tullus K

Study of urinary tract infection and bacteriuria in neonatal sepsis
Samayam P1, Ravi Chander B

To clean or not to clean: effect on contamination rates in midstream urine collections in toilet-trained children
Vaillancourt S1, McGillivray D, Zhang X, Kramer MS

The Uriscreen test was not better than standard urinalysis and dipstick tests for detecting urinary tract infection in children
Robert S Wigton, MD, MS

Urinary microbiome

The New World of the Urinary Microbiome in Women
Linda Brubaker and Alan J Wolfe

Biofilm Formartion and Antimicrobial Resistance Pattern Among Uropathogens
CharanKaur Dardi & Sanjivani Maral

Culturing of female bladder bacteria reveals an interconnected urogenital microbiota
Krystal Thomas-White, Samuel C. Forster, Nitin Kumar, Michelle Van Kuiken, Catherine Putonti, Mark D. Stares, Evann E. Hilt, Travis K. Price,Alan J. Wolfe & Trevor D. Lawley 2018

A case control study examining the bladder microbiome
Natasha Curtiss, Aswini Balachandrana, Louise Krskab, Claire Peppiatt-Wildmanb, Scott Wildmanb, Jonathan Ducketta 2017

Does the Urinary Microbiome Play a Role in Urgency Urinary Incontinence and Its Severity
Lisa Karstens , Mark Asquith, Sean Davin, Patrick Stauffer, Damien Fair W.Thomas Gregory, JamesT.Rosenbaum, Shannon K.McWeeney and Rahel Nardos 2016

Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract
Kimberly A. Kline and Amanda L. Lewis 2016

Microbial metagenome of urinary tract infection
Ahmed Moustafa, Harinder Singh, Weizhong Li, Kelvin J. Moncera, Manolito G. Torralba, Yanbao Yu, Oriol Manuel, William Biggs, J. Craig Venter, Karen E. Nelson, Rembert Pieper, Amalio Telenti 2017

The Urinary Microbiome and its Contribution to LUTS
Marcus J. Drake, Nicola Morris, Apostolos Apostolidis, Mohammad S. Rahnama and Julian R. Marchesi 2015

Intracellular bacterial communities

Intracellular lifestyles and immune evasion strategies of uropathogenic Escherichia coli.
By Hunstad DA & Justice SS

Intracellular Bacterial Communities: A Potential Etiology for Chronic Lower Urinary Tract Symptoms.
By Scott, Haake, Churchill, Justice & Kim

Detection of Intracellular Bacterial Communities in Human Urinary Tract Infection
By David A Rosen, Thomas M Hooton,Walter E Stamm, Peter A Humphrey & Scott J Hultgren

Detection of intracellular bacterial communities in a child with Escherichia coli recurrent urinary tract infections.
By Luciana Robino, Paola Scavone, Lucia Araujo, Gabriela Algorta, Pablo Zunino & Rafael Vignoli

Host subversion by formation of intracellular bacterial communities in the urinary tract
Gregory G. Anderson, Steven M. Martin, Scott J. Hultgren 2004

How to make it in the Urinary Tract – Intracellular communities
Ine Jorgensen, Patrick C. Seed 2012

UTI testing

Detecting clinically relevant microrganims we can do better
Paul C. Schreckenberger, Travis K. Price, Evann E. Hilt, Tanaka Dune, Cynthia Brincat, Linda Brubaker, Elizabeth R. Mueller, Alan J. Wolfe 2015

Detecting uropathogens in a urogynaecologic population: a comparison of UTI diagnostic thresholds
Price T, Hilt E, Dune T, Brincat C, Brubaker L, Mueller E, Schreckenberger P, Wolfe A – The International Continence Society 2017

The Problems affecting the diagnosis of urinary tract infection
Temenuga Dacheva & James Malone-Lee 2010

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. Schreckenberger 2014

Urine trouble: should we think differently about UTI?
K. Price & Evann E. Hilt & Tanaka J. Dune & Elizabeth R. Mueller & Alan J. Wolfe & Linda Brusker 2017

Women with symptoms of UTI but negative Urine test
Journal of Microbiology 2017— S Heytens, A De Sutter, L Coorevits, P Cools, J Buelens, L Van Simaey, T Christiaens, M Vaneechoutte, G Claeys 2017


Epidemiology of urinary tract infections: incidence, morbidity, and economic costs
Am J Med. 2002; 113:5–11S

The epidemiology of urinary tract infection
Foxman B1. Nat Rev Urol. 2010 Dec;7(12):653-60. doi: 10.1038/nrurol.2010.190

Diagnosis of coliform infection in acutely dysuric women
Stamm WE, Counts GW, Running KR, Fihn S, Turck M, Holmes KK.
N Engl J Med. 1982 Aug 19;307(8):463-8.

Common errors in diagnosis and management of urinary tract infection
Martina Franz & Walter H Horl.
Nephrology Dialysis Transplantation, Volume 14, Issue 11, 1 November 1999, Pages 2746–2753

Bacteria in the bladder wall of women with lower urinary tract symptoms: An interesting finding
By Vijaya G, Dutta S, Singh A U, Bray R, Digesu A, Fernando R, Khullar V.

Bad bugs and beleaguered bladders: interplay between uropathogenic Escherichia coli and innate host defenses
By Mulvey MA, Schilling JD, Martinez JJ & Hultgren SJ

Discrediting microscopic pyuria and leucocyte esterase as diagnostic surrogates for infection in patients with lower urinary tract symptoms: results from a clinical and laboratory evaluation
Kupelian AS, Horsley H, Khasriya R, Amussah RT, Badiani R, Courtney AM, Chandhyoke NS, Riaz U, Savlani K, Moledina M, Montes S, O’Connor D, Visavadia R, Kelsey M, Rohn JL, Malone-Lee J.

The unexplored relationship between urinary tract infections and the autonomic nervous system
By Hibbing, Conover & Hultgren

Urinary tract infections: epidemiology, mechanisms of infection and treatment options.
By Flores-Mireles, Walker, Caparon & Hultgren

From physiology to pharmacy: developments in the pathogenesis and treatment of recurrent urinary tract infections
By Silverman JA, Schreiber HL, Hooton TM & Hultgren SJ

Host-pathogen checkpoints and population bottlenecks in persistent and intracellular uropathogenic Escherichia coli bladder infection
By Hannan TJ, Totsika M, Mansfield KJ, Moore KH, Schembri MA & Hultgren SJ

Enterococcus faecalis Subverts and Invades the Host Urothelium in Patients with Chronic Urinary Tract Infection
By Harry Horsley, James Malone-Lee, David Holland, Madeleine Tuz, Andrew Hibbert, Michael Kelsey, Anthony Kupelian & Jennifer L. Rohn

Urine trouble: should we think differently about UTI?
K. Price & Evann E. Hilt & Tanaka J. Dune & Elizabeth R. Mueller & Alan J. Wolfe & Linda Brusker 2017

Women with symptoms of UTI but negative urine test Journal of Microbiology 2017
S Heytens, A De Sutter, L Coorevits, P Cools, J Buelens, L Van Simaey, T Christiaens, M Vaneechoutte, G Claeys 2017

The Clinical Urine Culture: Enhanced Techniques Improve Detection of 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. Schreckenberger