{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T20:05:38Z","timestamp":1793736338117,"version":"4.6.1"},"reference-count":54,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T00:00:00Z","timestamp":1742428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"charitable donations","award":["558771"],"award-info":[{"award-number":["558771"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Chronic urinary tract infection (UTI) presents with protracted lower urinary tract symptoms and elevated urinary leukocyte counts, but its bacterial etiological agents remain obscure. In this cross-sectional investigation, we aimed to unravel the role of the bladder microbiota in chronic UTI pathogenesis by studying the host immune response. Urine samples were collected from healthy controls (HT), chronic UTI patients who had not initiated treatment (PT) and those undergoing treatment (OT), then sorted into white blood cell (WBC) and epithelial cell (EPC) fractions. Bacteria associated with both fractions were identified by chromogenic agar culture coupled with mass spectrometry and 16S rRNA sequencing. Distinct WBC-exclusive bacteria were observed in the healthy population, but this pattern was less obvious in patients, plausibly due to epithelial shedding and breaching of the urothelial barrier. We also described a bacterial fingerprint guided by Escherichia that was able to stratify patients based on symptom severity. Clustering analyses of mean rank changes revealed highly statistically significant upward and downward ecological shifts in communities of bacteria between the healthy and diseased populations. Interestingly, many of the most abundant genera identified in sequencing remained stable when compared between the study cohorts. We concluded that reshuffling of the urinary microbiome, rather than the activity of a single known urinary pathogen, could drive chronic UTI.<\/jats:p>","DOI":"10.3390\/pathogens14030299","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T04:58:38Z","timestamp":1742533118000},"page":"299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Novel Techniques to Unravel Causative Bacterial Ecological Shifts in Chronic Urinary Tract Infection"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8414-9969","authenticated-orcid":false,"given":"Catherine C. Y.","family":"Chieng","sequence":"first","affiliation":[{"name":"Centre for Kidney and Bladder Health, University College London, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyang","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Microbial Diseases, Eastman Dental Institute, University College London, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha S. Y.","family":"Liou","sequence":"additional","affiliation":[{"name":"Centre for Kidney and Bladder Health, University College London, London NW3 2PF, UK"},{"name":"EGA Institute for Women\u2019s Health, University College London, London WC1E 6AU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u00f1a","family":"Neira Rey","sequence":"additional","affiliation":[{"name":"Centre for Kidney and Bladder Health, University College London, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9307-9901","authenticated-orcid":false,"given":"Katie L.","family":"Dalby","sequence":"additional","affiliation":[{"name":"Centre for Kidney and Bladder Health, University College London, London NW3 2PF, UK"},{"name":"Department of Microbial Diseases, Eastman Dental Institute, University College London, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Jones","sequence":"additional","affiliation":[{"name":"Microbiology Department, Whittington Health NHS Trust, London N19 5NF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajvinder","family":"Khasriya","sequence":"additional","affiliation":[{"name":"Department of Microbial Diseases, Eastman Dental Institute, University College London, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Horsley","sequence":"additional","affiliation":[{"name":"Centre for Kidney and Bladder Health, University College London, London NW3 2PF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Yang, X., Chen, H., Zheng, Y., Qu, S., Wang, H., and Yi, F. 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