Presentation Authors: Larissa Bresler*, Travis Price, Lauren Westbay, Cara Joyce, Mary Tulke, Colleen Fitzgerald, Alan Wolf, Maywood, IL
Introduction: Current etiology of interstitial cystitis/painful bladder syndrome (IC/PBS) is poorly understood and multifactorial. Treatments have limited success and/or problematic side effects. Recent studies suggest that the female lower urinary microbiota (FUM) of the urinary tract play a role in IC/PBS symptoms. This study was designed to determine if the FUM, analyzed using mid-stream voided urine samples, differs between IC/PBS patients and controls.
Methods: This prospective case-controlled study compared the voided FUM in women with symptoms of urinary frequency, urgency, and bladder pain for greater than 6 months meeting AUA IC/PBS definition. Bacterial identification was performed using 16S rRNA gene sequencing and EQUC, a validated enhanced urine culture approach. Urotypes were defined as genera present at >50% relative abundance. If no genera were present at this threshold, the urotype was classified as â€˜mixedâ€™. Chi-square and Fisherâ€™s exact tests were performed. P-values < 0.05 were considered significant.
Results: A mid-stream voided specimen was collected from 21 IC/PBS patients and 20 asymptomatic controls. The two groups had similar demographics and clinical characteristics (p>0.05 for all comparisons). Urotypes did not differ between cohorts as assessed by EQUC or 16S sequencing. We also detected no significant differences in any measure of alpha-diversity. By EQUC, there were some differences in community structure. Group B Streptococcus (p=0.045), Staphylococcus lugdunensis (p=0.048), and Corynebacterium aurimucosum (p=0.048) were more prevalent among asymptomatic controls, while Streptococcus mitis/oralis (p=0.042) was more common among those with IC/PBS. Escherichia coli was found more often in IC/PBS (5/21) than controls (1/20) (p=0.083). Detection of uropathogenic bacteria did not differ between groups.
Conclusions: Ours is the first study using modern culture and DNA sequencing methods to suggest that IC/PBS symptoms may not be related to differences in the FUM, at least not its bacterial components. Future larger studies are needed to confirm this preliminary finding.
Source of Funding: Interstitial Cystitis Association (ICA)