Search Results (69)

Trichomonas vaginalis is the protozoan parasite responsible for trichomoniasis, a prevalent non-viral sexually transmitted disease where high Zn²⁺ concentrations in the male prostate microenvironment function as a natural infection barrier. This study evaluates the post-transcriptional mechanisms governing the gene expression and mRNA stability of the 50 kDa metalloproteinase (TvMP50), an immunogenic biomarker for male trichomoniasis, under zinc stress. Using T. vaginalis female (CNCD147) and male (HGMN01) isolates, mp50 expression was characterized through transcription inhibition assays with Actinomycin-D, 5′ RACE, 3′ RACE, poly (A) tail assays (PAT-PCR), and Mfold secondary structure modeling. Results demonstrated that while transcription consistently initiates at a 10-nucleotide sequence relative to the start codon, the presence of 1.6 mM Zn²⁺ significantly stabilizes the transcript, extending its experimental half-life from 30 to 47 min. Furthermore, PAT-PCR and sequencing confirmed that Zn²⁺ exposure alters poly (A) tract lengths, reaching up to ~700 nucleotides, and utilizes alternative polyadenylation and cleavage sites to form stable 3′ untranslated region stem-loop configurations. In conclusion, mp50 overexpression under zinc stress is driven by a post-transcriptional mechanism where the synergistic effect of alternative processing signals and longer poly (A) tails enhances mRNA stability, optimizing parasite virulence during male urogenital colonization. Full article

The inappropriate utilization of traditional antimicrobials has expedited the development of multidrug-resistant bacterial strains, thereby generating an urgent demand for innovative, safe, and efficacious alternatives. Graphene oxide (GO), characterized by its distinctive physicochemical properties, holds significant potential for a wide range of biomedical applications, such as the prevention of oral diseases, periodontal therapy, control of gastrointestinal infections, wound healing, antibacterial therapy for the respiratory tract, and management of urogenital infections. The antimicrobial mechanisms of GO include physical disruption of microbial membranes, induction of reactive oxygen species (ROS), and its role as a photosensitizer. Moreover, improving the dispersion, stability, release behavior, and reusability of GO-based composites can markedly enhance their effectiveness. The antimicrobial activity of GO is further modulated by its physicochemical properties, synthesis methods, bacterial characteristics, and environmental conditions, while potential synergistic or antagonistic interactions remain to be elucidated. This review synthesizes recent advancements in GO-based antimicrobial strategies, elucidates key mechanisms and influencing factors, and addresses major challenges and future research directions, with the objective of facilitating the clinical translation of GO as a next-generation antimicrobial material. Full article

Background/Objectives: Recurrent urinary tract infection (rUTI) is common after menopause, but estrogen deficiency alone does not explain variation in recurrence, symptoms, and microbial profiles. This study aimed to synthesize evidence on the interactions among estrogen deficiency, urogenital microbial ecology, diabetes, obesity, microbial reservoirs, and anatomical, neurological, and functional modifiers of postmenopausal rUTI susceptibility. Methods: PubMed and Scopus were searched for original studies published from 1 January 2021 to 15 June 2026. A structured narrative synthesis included 62 original reports comprising clinical interventions, observational cohorts, microbiome and multi-omic studies, and cellular and animal experiments. Evidence was interpreted according to study design, population relevance, and biological directness. Results: Menopause was associated with reduced Lactobacillus dominance, higher vaginal pH, and altered vaginal or urinary communities, although findings were heterogeneous. Vaginal estrogen reduced recurrence and improved the local urogenital environment, but microbiome restoration is not established as its sole mechanism. Gut, rectal, vaginal, urinary, and bladder-wall reservoirs may contribute to persistence or repeated exposure. Diabetes was linked to dysbiosis and impaired urothelial defence, whereas obesity evidence remained less direct. Pelvic organ prolapse with incomplete emptying, elevated postvoid residual urine, age-related detrusor dysfunction, stroke, immobility, functional dependence, incontinence, and catheter exposure may further modify susceptibility. Conclusions: Postmenopausal rUTI is multifactorial. The urogenital microbiome–metabolic interface is a useful integrative framework, but not a validated causal or diagnostic model. Vaginal estrogen, urine culture, metabolic and bladder-function assessment, and antimicrobial stewardship remain the clinical foundation; microbiome-directed strategies require prospective validation. Full article

Urogenital toileting practices for residents in nursing homes (NHs) and their implications for the occurrence of bacteriuria remain largely unknown. Our purpose was to assess urogenital toileting practices in NHs in our region and their association with bacteriuria and urinary culture contamination rates. NHs reported on the direction of urogenital cleaning with respect to the urinary meatus and related practices during resident care over 7 years (2017 to 2023). Linear mixed models were used to relate two urogenital cleaning techniques, with bacteriuria rates (positive urinary cultures per resident over a year) and urinary culture contamination proportions. Of the 111 participating NHs, 33% used a technique involving outward cleaning with respect to the urinary meatus. Of these, 50 institutions had 7-year urinary microbiological data available (10,602 cultures, 13,059 isolates). Escherichia coli (45%) was the most frequently isolated microorganism while 12.4% of all cultures were contaminated (>3 microorganisms). We did not observe any significant association between the cleaning technique and the bacteriuria rates. The technique involving outward cleaning away from the urinary meatus was associated with lower odds of urinary culture contamination (odds ratio = 0.15, 95% CI: 0.05–0.48, p < 0.01). Urogenital cleaning techniques varied across participating institutions. We observed an association with urinary culture contamination, but not with bacteriuria rates. These findings warrant further investigation. Full article

Facklamia species are Gram-positive, catalase-negative cocci within the family Aerococcaceae. Historically misidentified as streptococci or enterococci due to phenotypic similarity and conventional biochemical testing limitations, their clinical significance remains incompletely defined. This narrative review synthesizes the current literature on the microbiology, epidemiology, clinical manifestations, diagnostic challenges, and antimicrobial susceptibilities of Facklamia infections, with emphasis on urogynecologic relevance. A structured literature search identified peer-reviewed reports of microbiologically confirmed human infection published through December 2025. These reports indicate global distribution and a broad clinical spectrum. Invasive infections were reported most often in older adults and individuals with structural abnormalities, chronic comorbidities, or recent surgical interventions; however, cases in otherwise healthy patients are described. Emerging microbiome data suggest that F. hominis may be enriched in adult females with lower urinary tract symptoms, supporting the possibility that the female urogenital tract functions as a potential reservoir and site of pathogenic activity. Antimicrobial susceptibility patterns vary, with documented resistance to penicillin, macrolides, clindamycin, and tetracyclines, and susceptibility to cephalosporins, vancomycin, and linezolid. Overall, Facklamia species should be recognized as underdiagnosed opportunistic pathogens with both invasive and urogynecologic relevance. Increased awareness, improved diagnostic identification, and systematic susceptibility profiling are needed to clarify their pathogenic role and guide appropriate antimicrobial therapy. Full article

Background/Objectives: Children with congenital urogenital anomalies (CUA) face increased risk of urinary tract infections (UTIs) and may harbor resistant organisms due to recurrent infections and antibiotic exposure. This study characterized the distribution of uropathogens and antimicrobial resistance patterns at a tertiary center in Saudi Arabia. Methods: This retrospective cohort study included pediatric patients (<18 years) with documented congenital urogenital anomalies and positive urine cultures at King Khalid University Hospital, Riyadh (2015–2025). Susceptibility interpretations (S/I/R) were extracted from the hospital laboratory information system; multidrug resistance (MDR) was defined using organism-specific Magiorakos criteria. Results: A total of 168 patients (72.0% male; mean age 4.1 ± 4.5 years) contributed 411 UTI episodes. Among 403 mono-organism episodes (after excluding eight polymicrobial cultures), Escherichia coli predominated (150/403, 37.2%), followed by Klebsiella pneumoniae (96/403, 23.8%) and Pseudomonas aeruginosa (33/403, 8.2%). High resistance was observed for ampicillin (83.6%), trimethoprim-sulfamethoxazole (54.2%), and cephalosporins (cefazolin 62.8%, cefotaxime 35.6%). Carbapenems (2.9%) and aminoglycosides (9.2%) retained >90% susceptibility. Overall MDR was 35.5%, highest among Klebsiella oxytoca (57.1%) and Escherichia coli (47.6%). Recurrent infections showed numerically higher unadjusted resistance than single episodes. Conclusions: Pediatric patients with congenital urogenital anomalies showed high first-line antibiotic resistance. Carbapenems and aminoglycosides retained predominantly susceptible in vitro profiles in this cohort and may inform empiric considerations alongside ongoing local susceptibility surveillance for this high-risk population. Full article

Background: Ureaplasma spp. and Mycoplasma hominis are urogenital pathogens that may be missed by routine culture, particularly in patients with genitourinary symptoms in whom conventional methods fail to identify an etiologic agent. Limited routine implementation of targeted diagnostics and antimicrobial susceptibility testing (AST) for these organisms may contribute to diagnostic uncertainty and treatment failure. Methods: Seventy-five midstream urine samples submitted for suspected urinary tract infection and positive for Ureaplasma spp. according to a q-PCR urinary panel (Bioeksen, İstanbul, Türkiye) were tested the same day with MYCOPLASMA IST3 (bioMérieux, Marcy-l’Étoile, France) to assess growth and antimicrobial susceptibility. Results: q-PCR detected U. parvum in 54/75 (72%), U. urealyticum in 15/75 (20%), and both species in 6/75 (8%); M. hominis was not included in the PCR panel. MYCOPLASMA IST3 showed growth in 70/75 samples (positive percent agreement, 93.33%), while 5/75 (discordance, 6.66%) showed no growth. Among culture-positive samples, 57/70 (81.42%) yielded Ureaplasma spp. alone, and 13/70 (18.58%) yielded Ureaplasma spp. together with M. hominis. Resistance to levofloxacin and tetracycline was observed in 15.7% and 12.9% of Ureaplasma spp. isolates, respectively; resistance to moxifloxacin, erythromycin, and telithromycin was observed in 2.9% of isolates for each agent. In M. hominis isolates, no resistance to levofloxacin, moxifloxacin, or tetracycline was observed, whereas clindamycin resistance was observed in 7.7% of isolates. Conclusions: In addition to intrinsic resistance, acquired antimicrobial resistance in Ureaplasma and Mycoplasma species appears to be increasing; therefore, treatment decisions should be guided by AST whenever feasible. Clinical laboratories should implement appropriate diagnostic methods for these organisms and perform susceptibility testing when indicated to support clinical decision making and optimize antimicrobial selection. Full article

Urinary tract infections (UTIs) impose a substantial burden on women’s health, and probiotics have emerged as an alternative strategy to support urogenital wellbeing. This study evaluated the antimicrobial properties of Limosilactobacillus reuteri 3613-1 and its ability to improve UTI outcomes in women with a history of recurrent uncomplicated UTIs. In vitro assays demonstrated that L. reuteri 3613-1 inhibited the growth of Escherichia coli isolates and proved superior inhibition of Gardnerella vaginalis and Candida albicans compared with a comparator L. reuteri strain, supported by confirmed reuterin production and genomic profiling. A randomized, double-blind, placebo-controlled clinical trial (n = 130) assessed daily supplementation with L. reuteri 3613-1 for 24 weeks. While the proportion, frequency, and intensity of confirmed UTIs did not differ significantly between groups, L. reuteri 3613-1 delayed the onset of the first UTI, reaching significance in participants with suspected while unconfirmed UTIs. Vaginal pH and vaginal microbiome composition remained stable and comparable between groups across the intervention. The product was safe and well tolerated. Overall, L. reuteri 3613-1 shows promise as a probiotic candidate with antimicrobial activity and potential to delay symptom onset in women susceptible to recurrent UTIs, warranting further investigation in larger studies. Full article

Background/Objectives: Stevens–Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, potentially fatal immunological conditions that affect cutaneous and mucosal surfaces and have the potential to involve the genitourinary tract. While genital involvement is common, urological manifestations are under-recognised clinically and there is a paucity of clear, evidence-based management pathways specific to urological manifestations of SJS/TEN. To map the spectrum of urological manifestations of SJS/TEN, to describe the short- and long-term outcomes of these manifestations, and to synthesise management and prevention strategies to inform clinical practice. Methods: This was a scoping review conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guideline. Data sources: Medline and PubMed articles published in English with publication date up to December 2025. Study selection: Eligible studies included case reports, case series, observational studies, clinical guidelines, and review articles describing urological manifestations, outcomes, management, or prevention strategies for patients with SJS/TEN. Articles limited to renal or isolated gynaecological involvement were excluded. Data extraction and synthesis: Articles were screened independently by two reviewers using a pre-defined data extraction template covering four domains: urological manifestations, outcomes and sequelae, management strategies, and prevention strategies. This criterion was refined after a pilot of 20 studies. Discrepancies were resolved by consensus with a third reviewer. Formal risk-of-bias assessment was not performed, consistent with scoping review methodology. Results: One hundred and four studies published between 1987 and 2025 were included in this review. Selected articles included case reports (n = 63), retrospective cohort studies (n = 23), prospective studies (n = 2), guidelines (n = 5), and summary articles (n = 11). Reported urological involvement ranged from genital cutaneous and mucosal disease including erosions, adhesions, and balanitis to urethral manifestations such as urethritis, stenosis, and strictures, as well as scarce upper urinary tract involvement including ureteric stricture and ureteric mucosal sloughing. While some manifestations resolved with supportive care, others progressed to chronic sequelae including persistent urethral strictures, voiding dysfunction, sexual dysfunction, recurrent infection, and in rare cases, obstructive uropathy. A multidisciplinary approach was recommended for all patients with SJS/TEN. Urological management centred around early and repeated urogenital examination, manual lysis of adhesions, urinary catheterisation, and timely intervention for urethral or ureteric obstruction. Long-term urological follow-up of 12 months was recommended for patients with significant urogenital involvement. Conclusions: Urological manifestations of SJS/TEN are diverse, clinically significant, and frequently under-recognised. Early urological involvement, systematic genital and urinary tract assessment, and proactive preventative measures may reduce long-term morbidity. This review provides a comprehensive synthesis of knowledge and recommendations to support urologists’ role in multidisciplinary care of patients with this pathology. This review also highlights the need for prospective research to guide further evidence-based management of urological complications of SJS/TEN. Full article

While Escherichia coli can be found in the bladders of females without lower urinary tract symptoms, its presence is often associated with urinary tract infections (UTIs). The genomic plasticity of E. coli, including urogenital strains, is largely shaped by the integration of prophages. Although genomic and metagenomic analyses of urinary E. coli and the urinary microbiome suggest that prophages are abundant, many represent uncharacterized species. Sequence analysis suggests that these prophages represent temperate phages. This study aimed to fill this gap, isolating and characterizing temperate phages from urinary E. coli strains. We assessed phage host range across a panel of urinary isolates, providing a critical first step for future work investigating their putative role in shaping E. coli populations within the urinary community. In total, 20 temperate urinary phages were evaluated. Phage morphology and genic content of these phages were determined via transmission electron microscopy (TEM) and whole-genome sequencing, respectively. Together, these analyses provide insight into the diversity, infectivity, and genomic composition of temperate coliphages from the female urinary tract. Full article

Background: Despite being a pillar of heart failure (HF) management, the guideline-directed initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2is) may be challenging due to the barrier of associated urinary tract infections (UTIs). Although there is a known risk, it remains unclear whether UTI incidence differs between patients with and without a prior history of UTIs. Methods: This study aimed to evaluate the risk–benefit profile of initiating an SGLT2i in patients with a history of UTIs. This retrospective, single-center healthcare system cohort analysis included adult patients hospitalized and taking an SGLT2i between 1 January 2020, and 31 August 2024. The included patients were divided into two cohorts: patients with and without a history of UTI pre-SGLT2i (described in this study as UTI-naive). Patients with urogenital structural abnormalities, indwelling catheters, or high-risk profiles were excluded. The primary outcome was the incidence of UTIs post-SGLT2i initiation. Secondary outcomes included the number of UTIs within 30, 60, and 90 days after starting an SGLT2i. Results: A total of 280 patients were evaluated for this study, of which 250 were included for analysis. Of those, 197 were UTI-naive, and 53 had a history of UTI pre-SGLT2i use. The most utilized SGLT2i was empagliflozin (75.6%). Amongst the cohorts, 20.4% of the UTI-naive patients developed a UTI post-SGLT2i versus 30.2% in patients with a historical UTI (p = 0.13). Conclusions: There was no significant difference in UTIs developed up to 90 days post-SGLT2i initiation, regardless of previous infections, suggesting that a history of UTI should not be a barrier to differing first-line therapy. Full article

Human microbiota, a complex consortium of microorganisms co-evolved with the host, profoundly influences tissue development, immune regulation, and disease progression. Growing evidence shows that microbial metabolites and signaling molecules modulate key stem cell pathways—such as Hedgehog, Wnt/β-catenin, and Notch—thereby reprogramming stem cell fate toward tumor-suppressive or tumor-promoting outcomes. Specific taxa within oral, intestinal, and urogenital niches have been linked to cancer initiation, therapy resistance, and recurrence. In parallel, clinical studies reveal that microbiota composition affects infection dynamics: bacterial isolates from symptomatic urinary tract infections inhibit commensal growth more strongly than the reverse, with Gram-positive and Gram-negative strains displaying distinct interaction profiles. Collectively, these findings highlight microbiota’s dual role in regulating cellular plasticity and pathogenicity. Elucidating host–microbe and microbe–microbe mechanisms may guide microbiota-targeted interventions to improve cancer and infectious disease management. Full article

Background: Antibiotics are commonly used in gynecology, yet only limited outpatient prescribing data are available in Germany. The aim of this study is to estimate the prevalence of antibiotic prescriptions in gynecological practices and to identify patient and diagnostic factors. Methods: A retrospective cross-sectional analysis was conducted using anonymized electronic records from the IQVIA Disease Analyzer, including 344,187 women aged ≥16 years who had at least one gynecological visit in 2024. The primary outcome of interest was the prescription of an antibiotic. Consequently, the prevalence of antibiotic prescriptions was calculated overall and stratified by age group. Associations between potential factors and antibiotic prescriptions were assessed using multivariable logistic regression. Results: The overall prescription prevalence was 8.4% (29,007/344,187). Regarding the age distribution within the prescribed sample, the highest percentages were observed among women aged 31–40 years (25.6%) and 16–30 years (25.4%), while those aged 51–60 and >60 made up 12.9% and 19.1%, respectively. The most commonly prescribed agents were fosfomycin trometamol (35.9%), clindamycin (17.6%), and pivmecillinam (10.7%). Mastitis (OR 63.54, 95% CI 55.79–72.38), acute cystitis (OR 43.67, 95% CI 41.63–45.80), and unspecified urinary tract infection (OR 31.58, 95% CI 20.11–33.12) were strongly positively associated with AB prescription. Positive associations were also observed for acute vaginitis (OR 3.44, 95% CI 3.30–3.58), chlamydial infection (OR 6.27, 95% CI 5.77–6.81), and pregnancy (OR 1.95, 95% CI 1.85–2.05). Negative associations were observed for dysmenorrhea (OR 0.52, 95% CI 0.48–0.56), irregular menstruation (OR 0.65, 95% CI 0.60–0.71), menopausal disorders (OR 0.51, 95% CI 0.48–0.53), and ovarian cysts (OR 0.78, 95% CI 0.72–0.84). Conclusions: Antibiotic use in gynecology is low and strongly diagnosis-driven, primarily for urogenital infections. Signals of inappropriate prescribing in patients with candidiasis suggest a need for improved diagnostic accuracy and guideline adherence. Full article

Mycoplasma hominis (MH) is a prevalent opportunistic pathogen that is strongly associated with a wide range of urogenital tract infections and severe adverse pregnancy outcomes in clinical settings. Current MH detection methods, including microbial culture and qPCR, are time-consuming and rely on complex equipment, making them unsuitable for scenarios requiring rapid or simplified testing. In this study, we developed a visual readout biosensing platform by synergistically integrating recombinase polymerase amplification (RPA), CRISPR/Cas12a-mediated target nucleic acid recognition, and lateral flow biosensors for the rapid, sensitive, and specific identification of MH. The assay specifically targets the MH-specific 16S rRNA gene, achieving a limit of detection as low as 2 copies/reaction of recombinant plasmid containing the target gene with a total assay time of 60 min. Critical reaction parameters, including Cas12a-crRNA molar ratio, volume of RPA amplicon input, and Cas12a cleavage time, were systematically optimized to maximize the biosensor’s response efficiency and detection reliability. The platform exhibited exceptional specificity, with no cross-reactivity observed against common co-occurring urogenital pathogens, and effectively minimized aerosol contamination risks via a rigorous decontamination workflow. Furthermore, this work represents the first documented implementation of a contamination-control protocol for an MH-specific CRISPR-LFA assay. Notably, testing results from 18 clinical samples demonstrated the high specificity of this assay, highlighting its promising potential for clinical application. Full article

Trichomoniasis is the most common non-viral sexually transmitted infection in humans, with over 200 million people affected each year. This disease is associated with pre-term birth, low birth weight, and premature membrane rupture. Its causal pathogen, Trichomonas vaginalis (TV), is a prevalent sexually transmitted protozoan parasite that infects the urogenital tract through cytoadherence. TV infection alters TV gene expression and induces host immune responses, while TV-secreted exosomes carry RNA and protein cargoes that mediate extracellular signaling. This review summarizes recent discoveries of molecules that interact with host receptors involved in cytoadherence. We also discuss human innate and adaptive immune responses to TV infection via a variety of inflammatory mediators. Recent research on concurrent or endosymbiont relationships of TV with other urogenital microbes and cancers, is also examined. These studies not only highlight the necessity of understanding host–microbe interactions in TV pathogenesis but also provide a crucial insight into potential therapeutic targets of nitroimidazole-resistant TV strains. Full article