The Lancet. Microbe · 2026
Role of the urobiome in urinary tract infections: current knowledge and research prospects.
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Hekker Marleen D, Bindas Adam J, Darling Eriksen Freya, Della Vedova Larissa, Giron-Villalobos David, Gallardo Molina Pablo, Koetsier Robert A, Berkers Celia R, Dutilh Bas E, Etienne Rampal S, Geerlings Suzanne E, van der Hooft Justin J J, Medema Marnix H, Schultsz Constance, Seidl Michael F, Wells Jerry M, Wolfe Alan J, van de Wijgert Janneke H H M, de Vos Marjon G J
Аннотация
Urinary tract infections (UTIs), particularly cystitis, are among the most common bacterial infections worldwide, with a disproportionate burden on adult female individuals, who often have recurrence. The discovery of the urobiome, a low microbial biomass community in the urinary tract, has transformed our understanding of UTI pathogenesis and infection susceptibility. Experimental and omics approaches provide insights into the taxonomic and functional complexity of the urobiome, highlighting the importance of microbial metabolites, ecological interactions, and host-microbe dynamics. Polymicrobial interactions within the urobiome further modulate pathogenicity, with some microbes inhibiting or promoting uropathobionts. Advancing UTI management will require combining omics and experimental research with ecological and evolutionary insights. This approach can enable the development of personalised, non-antibiotic interventions, such as live biotherapeutics and prebiotics, to improve diagnostics, reduce antibiotic resistance, and enhance treatment efficacy.