Open Access

ARTICLE

An implementation of next generation sequencing for prevention and diagnosis of urinary tract infection in urology

Vladimir Mouraviev¹, Michael McDonald²

1 Central Florida Cancer Institute, Davenport; Nova Southeastern University, Fort Lauderdale, Florida, USA
2 Department of Urology, Florida Hospital Celebration Health, Celebration; University of Central Florida, Orlando, Florida, USA
Address correspondence to Dr. Vladimir Mouraviev, Central Florida Cancer Institute, 40107 Highway 27, Davenport, FL 33837 USA

Canadian Journal of Urology 2018, 25(3), 9349-9356.

Abstract

Introduction: The changing face of current infection phenotypes — from planktonic to biofilm type — has increasingly implicated bacterial biofilms in recurrent infections. To date, no specific medical treatment exists that can effectively target biofilms within the human host. Similarly, the identification of biofilms has traditionally relied on tissue sample analysis using electron microscopy or DNA identification via polymerase chain reaction (PCR) and sequencing. Standard culture and sensitivity tests are not capable of detecting the presence of biofilms.
Materials and methods: Two types or "levels" of molecular microbial diagnostic testing were performed as described below. In both types of analysis, microbial DNA was extracted directly from the patient's sample. The resulting report included information on detected pathogenic bacterial and fungal microorganisms, bacterial load, and the presence of antibiotic resistance genes. Based on this data, antibiotic recommendations were made, guided by research confirming treatment effectiveness. This technique was tested in a cohort of 112 patients across various urological settings for both prevention and treatment purposes.
Results: The clinical application of next-generation DNA sequencing in phase I–II trials — including acute cystitis (56 patients), rectal swabs before transrectal prostate biopsy (32 men), neurogenic bladder (13 patients), and chronic bacterial prostatitis (17 men) — demonstrated that this novel approach expands our understanding of the microbiome of the urogenital tract in both men and women. DNA sequencing showed high sensitivity in detecting bacterial and fungal pathogens along with associated antibiotic resistance genes, enabling targeted and individualized prevention and treatment of urinary tract infections (UTIs), with improved efficacy compared to standard culture and sensitivity techniques.
Conclusion: Next-generation DNA sequencing technology enables a deeper understanding of the role of microorganisms in urinary tract diseases. It supports an individualized approach to the diagnosis, prevention, prophylaxis, and treatment of UTIs, offering more accurate and effective clinical outcomes.

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