Urinary Microbiome and Metabolome Differentiate Overactive Bladder From the Physiological State, and Reflect Recent Antibiotic Use and Treatment Response

PURPOSE: To characterize and compare the bacterial urinary microbiome in individuals with and without overactive bladder (OAB), and secondarily compare its composition by phenotype, comorbidities, recent antibiotic exposure, and therapeutic response. MATERIALS AND METHODS: We isolated DNA and metabolites from the urine of women without urologic diagnoses and with OAB. Bacterial profiles were generated with 16S rRNA sequencing, and metabolite profiles were generated with untargeted metabolomics. Alpha-diversity and beta-diversity, relative abundance, and microbe-metabolite co-occurrence interaction networks were identified by OAB status and patient characteristics. RESULTS: < .05). Microbe-metabolite interaction networks demonstrated central microbes and metabolites in the healthy and OAB states. CONCLUSIONS: The study provides new understanding regarding the physiological bacterial composition of urine, and that in the context of OAB. Furthermore, microbiota differed by patient phenotype, comorbidities, recent antibiotic exposure, and therapeutic response. The results inform strategies of microbiological modulation to augment existing therapeutic strategies.