MP20-08 PYURIA AND ASYMPTOMATIC BACTERIURIA IS ASSOCIATED WITH NOVEL AND SPECIFIC URINE MICROBIOMES

INTRODUCTION AND OBJECTIVES: Pyuria in the setting of asymptomatic bacteriuria (ABU), particularly in the context of potentially unrelated lower and upper urinary tract symptoms, may drive inappropriate use of antibiotics. A deeper comprehension of the relationship between pyuria and ABU will be essential in improving antibiotic use, especially in patients with neuropathic bladder, a disorder which features increased risk of ABU and UTI. METHODS: This is a cross-sectional study of asymptomatic subjects with normally functioning bladders (non-NB) and with neuropathic bladder (NB). Urine was obtained using the subject’s typical method of urine elimination (mid stream spontaneous void, sterile intermittent catheterization or aspiration from suprapubic tube). Samples were analyzed using 16S rRNA pyrosequencing in combination with Pathoscope 2.0, STAMP, urinalysis, and urine culture. RESULTS: All patients, regardless of bladder status and gender had bacteriuria based on 16s rRNA pyrosequencing with only 20/47 having positive urine cultures. Subjects with NB had significantly greater positive leukocyte esterase, pyuria, and cloudy urine on urinalysis, as well as bacterial growth on urine culture. Unique urine microbiomes were characterized for all subjects and grouped according to subject characteristics. Actinobaculum was found in significantly higher (p1⁄40.009) proportions of patients with pyuria. Whereas Lactobacillus was more abundant in patients without pyuria. CONCLUSIONS: Our data indicate that specific microbiomes are linked to pyuria-associated ABU. The discovery of a correlation between pyuria, ABU, and Actinobaculum, an emerging and poorly understood uropathogen, highlights the potential of microbial genomics to identify highly fastidious and non-culturable bacteria which may contribute to and drive lower urinary tract symptoms.