Editorial for Urogenital Tract Infection (UTI) 2025 Vol. 20 No. 2 – Highlights of This Issue’s Papers and the UTI Editors’ Pick
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On July 25, 2025, Urogenital Tract Infection (UTI; pISSN 2462-8243, eISSN 2465-8510) was officially indexed in the Directory of Open Access Journals (DOAJ). DOAJ is a comprehensive database that curates a wide range of open access journals from across the globe. Supported by a growing community, it is committed to providing high-quality scholarly content freely available online to everyone. The editorial team of UTI dedicated a year to preparing for DOAJ indexing and underwent a rigorous 3-month review process prior to final inclusion. As of now, DOAJ lists 21,765 journals from 138 countries, including 184 South Korean journals—UTI among them.
This month’s issue, the first since UTI’s DOAJ indexing, presents an in-depth examination of resistance mechanisms in urinary tract infections and features the latest updates from leading authors worldwide. The issue comprises four review articles, one original article, one case report, and one letter, each contributed by distinguished researchers from around the world.
Professor Hee Jo Yang [1] of Soonchunhyang University presents an evidence-based approach to asymptomatic bacteriuria (ASB) in older adults. Current guidelines recommend screening and treating ASB only in specific circumstances, such as before urological procedures or during pregnancy. This restriction is intended to prevent unnecessary antibiotic use, which can contribute to antimicrobial resistance. Reducing unwarranted urine testing and antibiotic prescriptions can mitigate overtreatment risks, including Clostridium difficile infections and antibiotic resistance. Professor Dechao Feng [2] of Sichuan University in China reports on beta-lactamase-mediated antibiotic resistance in urinary tract infections and associated therapeutic strategies. Beta-lactamase plays a central role in conferring resistance, employing mechanisms such as genetic mutations, plasmid-mediated horizontal gene transfer, and integron activity. Advances in detection technologies, including genetic sequencing and mass spectrometry, have improved the ability to monitor and predict bacterial resistance. Promising approaches include beta-lactamase inhibitors, novel antibiotic development, and alternative therapies shown to be effective against beta-lactamase-mediated resistance. Professor Byeongdo Song [3] of Hanyang University examines the urinary microbiome and its role in pediatric urinary tract infections. The urinary tract microbiome is now recognized as a key factor in maintaining urinary homeostasis, and its imbalance has been linked to an increased risk of various urinary tract diseases, including urinary tract infections. Professor Eun-Jin Lee [4] of Korea University provides a comprehensive review of antibiotic resistance in uropathogenic Escherichia coli (UPEC). This article analyzes the molecular mechanisms behind UPEC resistance to three major antibiotic classes, including target site modification, efflux pump overexpression, porin modulation, and enzymatic degradation. The review also discusses how these determinants drive the emergence of multidrug-resistant (MDR) UPEC strains, which exhibit cross-resistance and present major challenges in clinical care. Novel therapeutic strategies—such as efflux pump inhibitors, bacteriophage therapy, and genomics-based precision medicine—are under investigation, alongside non-antibiotic alternatives, to address the escalating global burden of MDR UPEC.
Professor Jin Bong Choi [5] of the Catholic University of Korea retrospectively evaluated the diagnostic performance of the Sysmex UF-5000 flow cytometer for detecting acute bacterial prostatitis (ABP) in comparison with standard urine culture. Among 45 patients, 84.4% had positive urine cultures. The bacterial count parameter demonstrated the highest diagnostic performance (area under the curve [AUC]=0.79; sensitivity, 89.5%; positive predictive value, 91.9%), surpassing white blood cell count (AUC=0.76) and red blood cell count (AUC=0.55). The Gram classification flag achieved 85.7% overall concordance with standard Gram staining, including an 88% concordance rate for Gram-negative organisms. These results suggest that the Sysmex UF-5000—especially through its bacterial count parameter—shows strong agreement with urine culture in ABP cases. While it cannot replace culture, it may serve as a valuable rapid adjunctive tool to support early clinical decisions in suspected ABP. Professor Young-Joo Kim [6] of Jeju National University reports a rare case of vesicouterine fistula after cesarean section, initially misdiagnosed as hemorrhagic cystitis. A 45-year-old woman presented with persistent vaginal urine leakage 3 weeks postcesarean section. Imaging confirmed a small vesicouterine fistula (<1 cm), which resolved spontaneously following conservative treatment with a Foley catheter. Four months later, she developed cyclical gross hematuria and dysuria without menstruation and was diagnosed with Youssef syndrome. Continuous oral contraceptive therapy successfully improved her hematuria, providing a noninvasive treatment option. This case underscores the importance of recognizing Youssef syndrome in patients with postcesarean cyclic hematuria and distinguishing it from hemorrhagic cystitis to ensure timely and appropriate care. Professor Byeong Jin Kang [7] of Pusan National University discusses the efficacy of Urovaxom in alleviating chronic pelvic pain syndrome (CPPS) symptoms in prostate cancer patients postradical prostatectomy. Urovaxom, a bacterial lysate with immunomodulatory properties, may restore immune balance, reduce neuroinflammation, and relieve pain and urinary symptoms. This study demonstrated significant reductions in National Institutes of Health Chronic Prostatitis Symptom Index, International Prostate Symptom Score, and Overactive Bladder Symptom Score, consistent with prior research showing that immune-based interventions can reduce sensory hypersensitivity in CPPS models. The article contributes valuable evidence to an understudied yet clinically relevant area and may encourage further mechanistic and translational research toward personalized CPPS care after radical prostatectomy.
In summary, this issue presents a comprehensive overview of cutting-edge research and clinical insights in the field. Notably, Professor Eun-Jin Lee’s review was chosen as the Editors’ Pick for its potential to broaden readers’ perspectives on antibiotic resistance in UPEC. As UTI’s inclusion in DOAJ enhances its international visibility, I encourage continued interest and support from experts in urogenital tract infections and inflammations seeking fresh, high-value information in this domain.
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Conflict of Interest
The author has nothing to disclose.