Urinary tract infections and microbiota

Abstract

Urinary tract infections (UTIs) are of considerable practical interest due to their high prevalence, presence of complications in the form of generalized infection with the development of sepsis, relapsing course, negative effects on the mother and fetus in pregnant women associated with the intensive use of antibacterial drugs leading to the development of Clostridioides diffcile-associated colitis and antibiotic resistance. The approaches to the treatment of urinary tract infections are undergoing changes. If earlier it was believed that urine is sterile and the detection of bacteriuria led to an unjustifed prescription of antibiotics, then now the introduction of new methods of urine testing has proved the opposite — asymptomatic bacteriuria is a fraction of the microbiota which normally inhabits the urinary tract and performs a protective role. New knowledge has led to an understanding of the negative impact of antibacterial drugs on the composition and the species diversity of the microorganisms of the urinary tract, genital tract, intestines, rethinking of approaches and indications for their prescription and search for alternative methods of patient treatment by modifying the diet, prescribing pre-, pro-, synbiotics, synthetic microbiota, vaccines, bacteriophages, microbiome transplantation.