Distinct Urinary Microbiome Signatures Are Associated with UTI Risk in Patients with Liver Cirrhosis: A Pilot Study

Individuals with liver cirrhosis are at increased risk of developing urinary tract infections (UTIs), yet the role of the urinary microbiome (UMB) in this susceptibility remains poorly understood. This pilot study aimed to characterize the UMB in patients with liver cirrhosis with and without UTIs using 16S rRNA gene sequencing. Urine samples from 39 patients were analyzed - 17 who developed at least one UTI (dUTI) within three years and 22 who remained UTI-free (no_UTI). Microbial profiles were assessed via 16S rRNA gene sequencing and analyzed using QIIME 2, ANCOM, and LEfSe. Significant differences in beta diversity were observed between the dUTI and no_UTI groups (Bray-Curtis ADONIS: R2=0.044, p=0.023; Jaccard ADONIS: R2=0.039, p=0.028). The no_UTI group exhibited higher relative abundances of Bacteroidetes, Prevotella, and Corynebacteriaceae - microbes typically associated with a healthy urinary environment. In contrast, Streptococcus was enriched in the dUTI group. Patients with liver cirrhosis who did not develop UTIs demonstrated distinct UMB patterns that may confer protection. These findings suggest that elements of the UMB, such as Prevotella and Corynebacterium, may play a protective role and represent potential targets for preventive strategies.