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World J Urol. 2019 Apr 26. doi: 10.1007/s00345-019-02764-0. [Epub ahead of print]

Urinary fungi associated with urinary symptom severity among women with interstitial cystitis/bladder pain syndrome (IC/BPS).

Author information

1
Department of Urology, Queen's University at Kingston, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada. jcn@queensu.ca.
2
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
3
National Institutes of Health/NIDDK, Bethesda, MD, USA.
4
Department of Pathology, University of Colorado, Aurora, CO, USA.
5
Division of Urology, Cedars-Sinai Medical Center, Beverly Hills, CA, USA.
6
Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
7
Department of Microbiology and Immunology, Drexel College of Medicine, Philadelphia, PA, USA.

Abstract

PURPOSE:

To correlate the presence of fungi with symptom flares, pain and urinary severity in a prospective, longitudinal study of women with IC/BPS enrolled in the MAPP Research Network.

METHODS:

Flare status, pelvic pain, urinary severity, and midstream urine were collected at baseline, 6 and 12 months from female IC/BPS participants with at least one flare and age-matched participants with no reported flares. Multilocus PCR coupled with electrospray ionization/mass spectrometry was used for identification of fungal species and genus. Associations between "mycobiome" (species/genus presence, relative abundance, Shannon's/Chao1 diversity indices) and current flare status, pain, urinary severity were evaluated using generalized linear mixed models, permutational multivariate analysis of variance, Wilcoxon's rank-sum test.

RESULTS:

The most specific analysis detected 13 fungal species from 8 genera in 504 urine samples from 202 females. A more sensitive analysis detected 43 genera. No overall differences were observed in fungal species/genus composition or diversity by flare status or pain severity. Longitudinal analyses suggested greater fungal diversity (Chao1 Mean Ratio 3.8, 95% CI 1.3-11.2, p = 0.02) and a significantly greater likelihood of detecting any fungal species (OR = 5.26, 95% CI 1.1-25.8, p = 0.04) in high vs low urinary severity participants. Individual taxa analysis showed a trend toward increased presence and relative abundance of Candida (OR = 6.63, 95% CI 0.8-58.5, p = 0.088) and Malassezia (only identified in 'high' urinary severity phenotype) for high vs low urinary symptoms.

CONCLUSION:

This analysis suggests the possibility that greater urinary symptom severity is associated with the urinary mycobiome urine in some females with IC/BPS.

KEYWORDS:

Bladder pain syndrome; Flares; Fungal; Interstitial cystitis; Mycobiome

PMID:
31028455
DOI:
10.1007/s00345-019-02764-0

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