Recurrent urinary tract infection and estrogen shape the taxonomic ecology and function of the postmenopausal urogenital microbiome

Michael L. Neugent, Ashwani Kumar, Neha V. Hulyalkar, Kevin C. Lutz, Vivian H. Nguyen, Jorge L. Fuentes, Cong Zhang, Amber Nguyen, Belle M. Sharon, Amy Kuprasertkul, Amanda P. Arute, Tahmineh Ebrahimzadeh, Nitya Natesan, Chao Xing, Vladimir Shulaev, Qiwei Li, Philippe E. Zimmern, Kelli L. Palmer, Nicole J. De Nisco

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Postmenopausal women are severely affected by recurrent urinary tract infection (rUTI). The urogenital microbiome is a key component of the urinary environment. However, changes in the urogenital microbiome underlying rUTI susceptibility are unknown. Here, we perform shotgun metagenomics and advanced culture on urine from a controlled cohort of postmenopausal women to identify urogenital microbiome compositional and function changes linked to rUTI susceptibility. We identify candidate taxonomic biomarkers of rUTI susceptibility in postmenopausal women and an enrichment of lactobacilli in postmenopausal women taking estrogen hormone therapy. We find robust correlations between Bifidobacterium and Lactobacillus and urinary estrogens in women without urinary tract infection (UTI) history. Functional analyses reveal distinct metabolic and antimicrobial resistance gene (ARG) signatures associated with rUTI. Importantly, we find that ARGs are enriched in the urogenital microbiomes of women with rUTI history independent of current UTI status. Our data suggest that rUTI and estrogen shape the urogenital microbiome in postmenopausal women.

Original languageEnglish (US)
Article number100753
JournalCell Reports Medicine
Issue number10
StatePublished - Oct 18 2022


  • Escherichia coli
  • Lactobacillus crispatus
  • antibiotic resistance
  • bladder
  • dysbiosis
  • estrogen
  • metagenomics
  • postmenopausal women
  • urinary tract infection
  • urogenital microbiome

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology


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