Disclosures Urine Trouble: Women's Bladder Health and the Urinary - PDF document

9/4/2019 Disclosures Urine Trouble: Women's Bladder Health and the Urinary Microbiome 1 2 Common Urogynecologic Who is Linda Brubaker? Clinical Stories Got Me Thinking � � � � � 3 4 1

9/4/2019 5 6 Detection of Bacteria (and other Organisms) 7 8 2

9/4/2019 DETECTING BACTERIAL DNA 16S rRNA GENE SEQUENCING �� � �� � � ��� � � ��� � � �� �� � � 9 10 Quick Classification Update Bacteria Eubacteria Proteobacteria Gammaproteobacteria Enterobacteriales Enterobacteriaceae Escherichia Escherichia coli 11 12 3

9/4/2019 Are the bacteria alive? Urobiome : there is a microbiota Are “culture negative” urines truly negative? in the female bladder 13 14 Standard EQUC Blood agar Blood agar 100 ul 1 ul 48 hours 24 hours This urine is not sterile 15 16 4

9/4/2019 Response to UUI Treatment Study Design • • • � � 17 18 Women and UTI 100 Number of Unique Bacterial Species Half of all women will get a UTI in their lifetime 80 30-50% experience recurrence of infection in 6-12 months 60 2-5% of experience recurrent UTIs (R-UTI) 40 Mainstay of treatment is antibiotics 20 per individual  adverse drug events  antibiotic resistance 0 0 5 10 15 20 25 30 35 40 45 50 55 Number of Unique Participants 19 20 5

9/4/2019 Antibiotic resistance threat 21 22 23 24 6

9/4/2019 In The Future � � � � � � 25 26 Funding U10 HD41250 27 28 7