Urogenital Tract Infection

Emerging Insights Into Microbiome Therapeutics for Urinary Tract Infections: A Narrative Review: Hoonhee Seo, Md Abdur Rahim, Indrajeet Barman, Mohammed Solayman Hossain, Hanieh Tajdozian, Fatemeh Ghorbanian, Md Sarower Hossen Shuvo, Jiho Choi, Sukyung Kim, Heejo Yang, Ho-Yeon Song; Urogenit Tract Infect 2025;20(1):4-16. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2448034017

Abstract PDF PubReader ePub: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, affecting millions annually and posing a significant global health concern. Traditional therapies for UTIs are becoming increasingly ineffective due to rising drug resistance and their tendency to disrupt the host's healthy microbiota, leading to further side effects. Consequently, there is an urgent need to develop alternative therapeutic agents that differ from conventional regimens and have fewer or no side effects. In this context, microbiome therapeutics offer a promising solution, given their demonstrated efficacy against various infectious diseases. Advances in scientific technology, particularly next-generation sequencing, have deepened our understanding of urinary microbiome dynamics, revealing a complex interplay within the urobiome that influences the onset and progression of UTIs. Uropathogenic bacteria do not solely cause UTIs; shifts in the composition of the urinary microbiome and interactions within the microbial community, known as host-microbiota interactions, also play a significant role. Although recent studies underscore the potential of targeting the urinary microbiome to manage UTIs and related complications, this field is still emerging and faces numerous regulatory and technical challenges. Further in-depth and comprehensive research is required to advance this pioneering concept into clinical practice.

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Efficacy of Urovaxom for Improving Chronic Pelvic Pain Syndrome Symptoms in Prostate Cancer Patients Who Underwent Radical Prostatectomy: A Multicenter, Prospective Cohort Study: Jun-Koo Kang, Yun-Sok Ha, Sungchan Park, Tae Gyun Kwon, Tae-Hwan Kim; Urogenit Tract Infect 2025;20(1):42-47. Published online April 30, 2025; DOI: https://doi.org/10.14777/uti.2550014007

Abstract PDF PubReader ePub: Purpose
Chronic pelvic pain syndrome (CPPS) is a multifactorial condition that can significantly diminish quality of life. Although some patients have reported persistent pelvic pain after radical prostatectomy (RP), the prevalence and direct causal relationship between CPPS and RP remain unclear. This multicenter prospective study aimed to evaluate the efficacy of Urovaxom for improving CPPS symptoms. Materials and Methods: A total of 52 prostate cancer patients who underwent RP were enrolled and administered Urovaxom (60 mg/day) for 12 weeks. Changes in National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), overactive bladder symptom score (OABSS), International Prostate Symptom Score (IPSS), and inflammation markers (white blood cell [WBC], C-reactive protein [CRP]) were analyzed using the Wilcoxon signed-rank test.
Results
After 12 weeks of treatment, the NIH-CPSI total score significantly decreased from 19 (interquartile range [IQR], 16–23) to 12.5 (IQR, 8.0–16.8) (p<0.001). The OABSS total score decreased from 8 (IQR, 4–11) to 5 (IQR, 3.0–7.8), and the IPSS total score decreased from 13.5 (IQR, 10.0–22.8) to 10.5 (IQR, 5.0–17.0) (p<0.001). WBC levels showed a slight increase (p=0.028), but the clinical relevance of this change is uncertain and warrants further investigation. CRP changes were not statistically significant (p=0.274).
Conclusions
Urovaxom demonstrated significant efficacy in improving CPPS symptoms, particularly pain and reduced quality of life, in patients following RP. These findings suggest Urovaxom as a potential therapeutic option for CPPS after management using RP.

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Mechanistic Insights Into Persistent Bacterial Cystitis as a Basis for Vaccine Development: A Narrative Review: Karen Serrano-Arevalo, Manisha Naskar, Hae Woong Choi; Urogenit Tract Infect 2024;19(3):60-72. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448022011

Abstract PDF PubReader ePub: Urinary tract infections (UTIs) are primarily caused by uropathogenic Escherichia coli (UPEC), which frequently lead to recurrent infections. These bacteria utilize several strategies to establish infection in the host; in particular, virulence factors such as fimbriae and α-hemolysin facilitate persistent infection, evade host immune responses, and minimize antibiotic exposure. To date, antibiotics have been the primary treatment for UTIs. However, an increasing emphasis has been placed on the need for UTI vaccines, with mucosal vaccine products now available in several countries. Additionally, vaccines targeting intracellular UPEC, utilizing adjuvants, are currently under development. Understanding the pathogenic mechanisms of uropathogens has enabled the development of new treatment approaches, paving the way for next-generation preventive and therapeutic methods that could effectively manage recurrent UTIs in the future.

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Postoperative Microscopic Pyuria and Role of Damage-Associated Molecular Pattern: A Literature Review: Min-Kyu Kim, Ki Hong Kim; Urogenit Tract Infect 2024;19(3):73-79. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448026013

Abstract PDF PubReader ePub: All patients who undergo transurethral prostate surgery exhibit pyuria and microscopic hematuria in postoperative urinalysis. Postoperative asymptomatic pyuria is associated with the inflammatory process and surface remodeling of the prostate, rather than infection. Various studies have investigated the incidence, duration, and risk factors for postoperative pyuria, noting that factors like age, surgery time, and prostate size can influence outcomes. Postoperative pyuria reflects tissue recovery and inflammation, and the use of antibiotics in asymptomatic patients may not be appropriate.

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Outbreak of Cystoscopy-Related Urinary Tract Infections With Pseudomonas aeruginosa in South Korea, 2022: A Case Series: Beomsoo Kim, Young-Sin Choi, Jun-Koo Kang, Yun-Sok Ha, Seock Hwan Choi, Bum Soo Kim, Hyun Tae Kim, Eun Sang Yoo, Tae Gyun Kwon, Jae-Wook Chung, Tae-Hwan Kim; Urogenit Tract Infect 2024;19(3):97-103. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448028014

Abstract PDF PubReader ePub: Purpose
This study conducted an epidemiological investigation of Pseudomonas aeruginosa urinary tract infections (UTIs) following cystoscopy at Chilgok Kyungpook National University Hospital. Materials and Methods: From May 16 to July 15, 2022, among 353 patients who underwent cystoscopy, 6 patients reported febrile UTIs following cystoscopy. They were admitted to the urology department of the hospital after visiting the Emergency Department. P. aeruginosa was found in the urine cultures of 4 of the 6 hospitalized patients. During the epidemiological investigation, no changes were observed in factors such as the reprocessing procedures for endoscopic equipment. Therefore, microbiological tests were performed using environmental samples derived from the endoscopic equipment and cleaning process.
Results
P. aeruginosa was identified in a dual-enzymatic detergent (EmPower) used during the endoscope cleaning process. After changing the disinfectant and cleaning process, no further bacterial growth was observed in subsequent microbiological tests.
Conclusions
This study highlights the potential of cystoscopes to serve as reservoirs for bacteria due to inadequate cleaning during the disinfection process. To minimize the risk of infections following cystoscopy, it is important to pay close attention to the reprocessing and cleaning of cystoscopes.

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Funded Articles