# The Urinary Microbiome in Women Using Single‐Use Versus Reusable Catheters for Intermittent Catheterization: An Exploratory Substudy of the COMPaRE Trial

## TL;DR

This study explores how using reusable versus single-use catheters affects the urinary microbiome in women, finding shifts in specific bacteria but no overall diversity changes.

## Contribution

The study identifies specific microbial shifts associated with catheter type transition and factors like age and menopausal status.

## Key findings

- Escherichia-Shigella and Lactobacillus were the most prevalent genera in the urinary microbiome.
- Transitioning to reusable catheters reduced Escherichia-Shigella and Aerococcus while increasing Veillonella and Finegoldia.
- No significant changes in urine culture results or microbial diversity were observed.

## Abstract

To characterize the urinary microbiome in women performing clean intermittent self‐catheterization (CISC) and explore microbial changes associated with transitioning from single‐use to reusable catheters.

This microbiome study of the COMPaRE trial included female CISC patients with urinary retention randomized to either single‐use or reusable catheters. Self‐catheterized urine samples were collected at baseline and Week 6 for standard culture and 16S rRNA microbiome analysis.

A total of 28 patients (12 reusable, 16 single‐use) were included, with a median age of 48 years (IQR 32−60); 67.9% had neurogenic lower urinary tract dysfunction. Escherichia‐Shigella (36.3%) and Lactobacillus (22.8%) were the most prevalent genera. PERMANOVA identified significant effects of age (p = 0.003), menopausal status (p < 0.001), and catheterization cause (p = 0.003) on microbiome composition. Transitioning to reusable catheters was associated with significant reductions in Escherichia‐Shigella (p < 0.001) and Aerococcus (p < 0.001), and increases in Veillonella (p < 0.001) and Finegoldia (p < 0.001). No significant changes were observed in urine culture results (p = 0.250), alpha diversity as measured by the Shannon index (p = 0.862), or beta diversity as assessed by Bray‐Curtis distance (p = 0.096).

Escherichia‐Shigella and Lactobacillus were the most abundant genera in the urinary microbiome of women performing CISC. Age, menopausal status, and catheterization cause significantly influenced microbiome composition. Although specific microbial shifts were observed following transition to reusable catheters, no significant changes in overall microbial diversity were detected. Larger, well‐powered studies are needed to validate these results and assess their potential clinical implications. Trial Registration: Clinical Trial RegistrationNL‐OMON54700/NL8296.