Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone Disease
The discovery of a resident urinary microbiome has significantly altered the understanding of urolithiasis, expanding its etiology beyond metabolic and dietary factors to include microbial contributions. This review highlights how specific uropathogens—particularly <i>Proteus mirabilis</i&g...
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MDPI AG
2025-07-01
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| Series: | Pharmaceuticals |
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| Online Access: | https://www.mdpi.com/1424-8247/18/7/1038 |
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| author | Oana Nicu-Canareica Vlad-Octavian Bolocan Loredana Sabina Cornelia Manolescu Petru Armean Cosmin Medar Liliana Burlibașa Maria-Luiza Băean Viorel Jinga |
| author_facet | Oana Nicu-Canareica Vlad-Octavian Bolocan Loredana Sabina Cornelia Manolescu Petru Armean Cosmin Medar Liliana Burlibașa Maria-Luiza Băean Viorel Jinga |
| author_sort | Oana Nicu-Canareica |
| collection | DOAJ |
| description | The discovery of a resident urinary microbiome has significantly altered the understanding of urolithiasis, expanding its etiology beyond metabolic and dietary factors to include microbial contributions. This review highlights how specific uropathogens—particularly <i>Proteus mirabilis</i>, <i>Klebsiella pneumoniae</i>, and <i>Escherichia coli</i>—facilitate stone formation through mechanisms such as urease activity, citrate degradation, urine alkalinization, biofilm development, and inflammatory signaling. We critically examine how antibiotic therapies, while essential for treating urinary tract infections (UTIs), disrupt microbial homeostasis by depleting beneficial taxa like <i>Lactobacillus</i> and enabling colonization by lithogenic and resistant strains. Recurrent or broad-spectrum antibiotic use is linked to persistent dysbiosis and increased risk of stone recurrence. Additionally, this paper explores emerging microbiome-targeted strategies—such as probiotics, prebiotics, bacteriotherapy, and precision antimicrobials—as potential interventions to restore microbial balance and mitigate stone risk. Recognizing the urinary microbiome as a therapeutic target opens new avenues for personalized, microbiota-conscious strategies in the prevention and management of kidney stone disease. |
| format | Article |
| id | doaj-art-b49a2082b1fc404ba9e3cbc08a7b4882 |
| institution | DOAJ |
| issn | 1424-8247 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj-art-b49a2082b1fc404ba9e3cbc08a7b48822025-08-20T02:47:07ZengMDPI AGPharmaceuticals1424-82472025-07-01187103810.3390/ph18071038Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone DiseaseOana Nicu-Canareica0Vlad-Octavian Bolocan1Loredana Sabina Cornelia Manolescu2Petru Armean3Cosmin Medar4Liliana Burlibașa5Maria-Luiza Băean6Viorel Jinga7Doctoral Program Studies, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, RomaniaDoctoral Program Studies, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, RomaniaDepartment of Fundamental Sciences, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, RomaniaDiscipline of Public Health and Management, Department of Specific Sciences, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, RomaniaDepartment of Fundamental Sciences, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, RomaniaGenetics Department, Faculty of Biology, University of Bucharest, 060101 Bucharest, RomaniaDepartment of Fundamental Sciences, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, RomaniaDepartment of Urology, Clinical Hospital “Prof. Dr. Theodor Burghele”, Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, RomaniaThe discovery of a resident urinary microbiome has significantly altered the understanding of urolithiasis, expanding its etiology beyond metabolic and dietary factors to include microbial contributions. This review highlights how specific uropathogens—particularly <i>Proteus mirabilis</i>, <i>Klebsiella pneumoniae</i>, and <i>Escherichia coli</i>—facilitate stone formation through mechanisms such as urease activity, citrate degradation, urine alkalinization, biofilm development, and inflammatory signaling. We critically examine how antibiotic therapies, while essential for treating urinary tract infections (UTIs), disrupt microbial homeostasis by depleting beneficial taxa like <i>Lactobacillus</i> and enabling colonization by lithogenic and resistant strains. Recurrent or broad-spectrum antibiotic use is linked to persistent dysbiosis and increased risk of stone recurrence. Additionally, this paper explores emerging microbiome-targeted strategies—such as probiotics, prebiotics, bacteriotherapy, and precision antimicrobials—as potential interventions to restore microbial balance and mitigate stone risk. Recognizing the urinary microbiome as a therapeutic target opens new avenues for personalized, microbiota-conscious strategies in the prevention and management of kidney stone disease.https://www.mdpi.com/1424-8247/18/7/1038urolithiasismicrobiotaantibioticsdysbiosisinfectionprobiotics |
| spellingShingle | Oana Nicu-Canareica Vlad-Octavian Bolocan Loredana Sabina Cornelia Manolescu Petru Armean Cosmin Medar Liliana Burlibașa Maria-Luiza Băean Viorel Jinga Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone Disease Pharmaceuticals urolithiasis microbiota antibiotics dysbiosis infection probiotics |
| title | Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone Disease |
| title_full | Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone Disease |
| title_fullStr | Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone Disease |
| title_full_unstemmed | Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone Disease |
| title_short | Beyond Infection: How Antimicrobial Therapies Influence the Urinary Microbiome and Stone Disease |
| title_sort | beyond infection how antimicrobial therapies influence the urinary microbiome and stone disease |
| topic | urolithiasis microbiota antibiotics dysbiosis infection probiotics |
| url | https://www.mdpi.com/1424-8247/18/7/1038 |
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