{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:25:44Z","timestamp":1792099544681,"version":"4.4.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Recurrent urinary tract infections (rUTIs) in postmenopausal (PM) women pose a significant clinical challenge, complicated by rising antibiotic resistance among uropathogens. The vaginal microbiota in this population remains underexplored. We aim to characterize vaginal flora of PM women with and without a history of rUTIs, and to evaluate relationships to demographic variables, clinical characteristics, and rectal pathogen colonization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a cross-sectional study of 62 PM women (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f31 rUTI, (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f31 control). Vaginal swabs were analyzed using 16S rRNA and a next-generation sequencing tool designed to identify UTI pathogens and antibiotic resistance (AMR) markers. Rectal swabs were cultured to identify uropathogens and their phenotypic resistance. These were integrated with subject demographic and historical clinical data.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to controls, rUTI vaginal microbiota exhibited a marked depletion in\n                      <jats:italic>Lactobacillus crispatus<\/jats:italic>\n                      and\n                      <jats:italic>L. iners<\/jats:italic>\n                      , species commonly associated with vaginal health, alongside an enrichment of\n                      <jats:italic>L. gasseri<\/jats:italic>\n                      and\n                      <jats:italic>L. jensenii<\/jats:italic>\n                      . The rUTI cohort also had a greater burden of AMR markers (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0003). Notably, Gram-negative uropathogens in the rUTI group frequently carried multidrug resistance genes, at rates nearly three times higher than controls. The rUTI cohort was further characterized by enrichment of Gram-negative uropathogens in the vagina. These alterations were more pronounced with increasing years in menopause.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The rectum emerged as a key reservoir, with notable concordance of organisms across rectal and urogenital sites. Our findings indicate that rUTIs in postmenopausal women are associated with a dysbiotic vaginal microbiome that is closely linked to a rectal reservoir of multidrug-resistant uropathogens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1812000","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:50:38Z","timestamp":1775555438000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Vaginal microbiome dysbiosis and a rectal reservoir of uropathogens characterize postmenopausal women with recurrent urinary tract infections: a cross-sectional study"],"prefix":"10.3389","volume":"17","author":[{"given":"Timothy S.","family":"Horseman","sequence":"first","affiliation":[{"name":"United States Army Institute of Surgical Research","place":["Joint Base San Antonio\u2013Fort Sam Houston, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith S. K.","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Clinical Investigation, Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie L.","family":"Dombach","sequence":"additional","affiliation":[{"name":"Department of Clinical Investigation, Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Kamau","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan P.","family":"Gehrich","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Urogynecology, Tripler Army Medical Center","place":["Honolulu, HI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/JU.0000000000004723","article-title":"Updates to recurrent uncomplicated urinary tract infections in women: AUA\/CUA\/SUFU guideline (2025)","volume":"215","author":"Ackerman","year":"2026","journal-title":"J. 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Microbiol."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1812000\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:50:41Z","timestamp":1775555441000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1812000\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":37,"alternative-id":["10.3389\/fmicb.2026.1812000"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2026.1812000","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"article-number":"1812000"}}