{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:50:19Z","timestamp":1791939019422,"version":"4.3.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["R61AT013008"],"award-info":[{"award-number":["R61AT013008"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["R01DK138121"],"award-info":[{"award-number":["R01DK138121"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["U01 DK106892"],"award-info":[{"award-number":["U01 DK106892"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"NIDDK","doi-asserted-by":"publisher","award":["K08DK118176"],"award-info":[{"award-number":["K08DK118176"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"DOD","doi-asserted-by":"publisher","award":["PR200027"],"award-info":[{"award-number":["PR200027"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"DOD","doi-asserted-by":"publisher","award":["PR240809"],"award-info":[{"award-number":["PR240809"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Abbvie"},{"name":"Watershed Medical"},{"name":"Desert Harvest"},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NowWell"},{"name":"LiviWell"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Quantitative polymerase chain reaction (qPCR) has high sensitivity in detecting uropathogens. While qPCR is increasingly used in urinary tract infection (UTI) diagnosis, its accuracy distinguishing UTI from noninfectious lower urinary tract symptoms (LUTS) is unclear. This study sought to assess qPCR utility in distinguishing UTI from noninfectious LUTS and controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Quantitative polymerase chain reaction examined urinary DNA from 502 women with UTI (UTI, n = 104), noninfectious LUTS (n = 354), or controls (n = 44) for uropathogens (Escherichia coli, Klebsiella pneumoniae, Enterococcus), Lactobacilli, bacterial vaginosis-associated bacteria (Gardnerella, Prevotella, Burkholderia), and Candida albicans. Relative bacterial DNA quantities were compared across groups and menopausal strata by logistic regression. Receiver operating characteristic analysis of continuous qPCR values assessed the ability of individual and combined microbial species to distinguish UTI from LUTS and controls, with AUC \u2265 0.7 as the discrimination threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Almost all women had detectable urinary E. coli (97.3%), Enterococcus (99.2%), K. pneumoniae (73.4%), and C. albicans (94.2%) DNA. No qPCR detection threshold could distinguish symptomatic UTI subjects from controls or noninfectious LUTS. Decreased Lactobacillus crispatus, Lactobacillus iners, and Burkholderia were seen in UTI subjects. Postmenopausal women had higher E. coli (P = .023) and Enterococcus (P = .002) levels and lower Lactobacillus (P &amp;lt; .001) than premenopausal women. In premenopausal women, vaginal species alone and in combination with uropathogens modestly discriminated UTI from LUTS (AUC &amp;gt; 0.7), although no model achieved discrimination in postmenopausal women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women with UTI, noninfectious LUTS, and controls exhibit similar uropathogen levels by qPCR. Providers should exercise caution using qPCR-based tests in women without a high suspicion for UTI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag479","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:35:37Z","timestamp":1786448137000},"source":"Crossref","is-referenced-by-count":0,"title":["Quantitative PCR Bacterial Levels Cannot Distinguish Recurrent Urinary Tract Infection From Other Noninfectious Urinary Symptoms"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6371-206X","authenticated-orcid":false,"given":"Alec","family":"Szlachta-McGinn","sequence":"first","affiliation":[{"name":"Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Washington University in St. Louis , St. Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0130-8659","authenticated-orcid":false,"given":"Ann E","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Disease, Department of Medicine, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-5050","authenticated-orcid":false,"given":"Nicholas J","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Medicine Statistics Core, University of California Los Angeles , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-7649","authenticated-orcid":false,"given":"A Lenore","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Division of Pelvic Medicine and Reconstructive Surgery, 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