Investigating Urine Microbiota and Metabolites in Female Patients with Cystitis Glandularis: A Comprehensive Analysis Using High-Throughput 16S rRNA Sequencing and Metabolomics

Cystitis Glandularis (CG) is a condition that negatively impacts the quality of life in women, often resulting in recurrent urinary tract infections and bladder dysfunction. Existing antibiotic therapies and symptom-focused transurethral resection have proven inadequate. This study aimed to investigate the urinary microbiota diversity and metabolic complexity in female patients with CG before and after treatment, using high-throughput 16S rRNA sequencing and metabolomics analysis. The results indicated a significant reduction in beneficial genera such as Gardnerella, Lactobacillus, and Prevotella in CG patients compared to healthy controls, while an increase was observed in pathogenic taxa such as Acinetobacter, Bacteroides, Enterococcus, Vibrio, and Escherichia-Shigella. Moreover, following antibiotic treatment, a notable decrease in Escherichia-Shigella was observed, along with a slight reduction in Acinetobacter and Bacteroides; however, the abundance of Enterococcus and Vibrio remained unchanged. Additionally, antibiotic treatment correlated with an increase in Ralstonia and Staphylococcus. Metabolomic profiling revealed that 15 out of the top 20 differential metabolites were significantly increased in the treatment group compared to pre-treatment levels. Correlation analyses showed that bacteria associated with healthy controls were positively linked with metabolites such as ephedrine and N-acetylhistidine. In contrast, treatment-associated bacteria, Staphylococcus and Vibrio, exhibited opposite correlations. These findings suggest that current antibiotic treatments are insufficient in restoring microbial equilibrium, potentially exacerbating microbial dysbiosis and metabolic imbalances, thereby contributing to suboptimal outcomes in CG management. This highlights the need for alternative therapeutic strategies to maintain microbial health and enhance treatment efficacy.