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This creates an environment where opportunistic pathogens thrive while beneficial bowel flora diminish [3]. There is an association among the bowel, vaginal and bladder microbiomes where the bacteria from the bowel are found in the bladder [4]. Urinary tract infections (UTIs) are among the most common bacterial infections, typically caused by\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (\n                      <jats:italic>E. coli<\/jats:italic>\n                      ),\n                      <jats:italic>Enterococcus faecalis (E. faecalis)<\/jats:italic>\n                      ,\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp, and\n                      <jats:italic>Proteus mirabilis<\/jats:italic>\n                      (\n                      <jats:italic>P. mirabilis<\/jats:italic>\n                      ) in women [5]. Changes in the bowel microbiome lead to changes in the bladder microbiome [6]. We aimed to evaluate whether the composition of observed uropathogens differed across the different phases of the COVID-19 pandemic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study analysed positive urine cultures from women before, during and after the COVID-19 pandemic. The leading three causative uropathogens with a count over 10\n                      <jats:sup>3<\/jats:sup>\n                      \u00a0cfu\/mL were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 5543 positive cultures with pre-COVID-19 from 1 January 2019 to 30 January 2020,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009204, during from 1 February 2020 to 4 May 2023,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092518, and after from 5 May 2023 to 1 February 2025,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092821. In total, 10,456 bacteria were identified. After May 2023,\n                      <jats:italic>E. coli<\/jats:italic>\n                      prevalence dropped from 27 to 21%, and\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      spp decreased from 6 to 2% (\n                      <jats:italic>p<\/jats:italic>\n                      value\u2009&lt;\u20090.001). In contrast,\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp incidence rose from 8 to 12%.\n                      <jats:italic>Corynebacterium<\/jats:italic>\n                      spp (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and\n                      <jats:italic>Acinetobacter<\/jats:italic>\n                      spp (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were increasingly isolated in symptomatic UTIs after May 2023.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The bacterial organisms found in urinary tract infections detected before and subsequent to the onset of COVID-19 have changed. This may reflect an interaction between changes in the bowel microbiome and pathological urinary tract infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-026-06765-7","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T14:09:30Z","timestamp":1781964570000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in Uropathogen Distribution in Relation to the COVID-19 Pandemic Timeline"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9270-7948","authenticated-orcid":false,"given":"Miriam","family":"Tadros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-656X","authenticated-orcid":false,"given":"Bernadette","family":"Lemmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alka","family":"Bhide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Digesu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruwan","family":"Fernando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-7495","authenticated-orcid":false,"given":"Vik","family":"Khullar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"6765_CR1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.25441","author":"V Khullar","year":"2024","unstructured":"Khullar V, Lemmon B, Acar O, Abrams P, Vahabi B. 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NHS England; 2022."}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06765-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-026-06765-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06765-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T14:09:37Z","timestamp":1781964577000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-026-06765-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,20]]},"references-count":41,"alternative-id":["6765"],"URL":"https:\/\/doi.org\/10.1007\/s00192-026-06765-7","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,20]]},"assertion":[{"value":"9 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"IRB approval was not sought because the study comprised a retrospective review of existing results and did not involve interaction with human subjects or the collection of identifiable data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"At British Society of Urogynaecologists, Royal College of Obstetricians and Gynaecologists, London, November 2025.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Previously Presented"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}}]}}