The Role of the Microbiome and OM-89 in the Prevention of Recurrent Urinary Tract Infections
DOI: magyurol.2026.1.tothzsf.28
Authors:
Tóth Zsófia Fruzsina dr.
Szabolcs-Szatmár-Bereg Vármegyei Oktatókórház, Nyíregyházi Jósa András Tagkórház, Urológiai osztály, Nyíregyháza
Summary
Recurrent urinary tract infections represent a common challenge in urological practice and are associated with a considerable reduction in quality of life and increased healthcare utilization. Antibiotic therapy remains effective for the treatment of acute infections; however, repeated administration adversely affects the physiological balance of the microbiome and promotes the development of antimicrobial resistance. Recent studies have demonstrated that, beyond the presence of uropathogenic bacteria, host related factors such as the microbiome and immune response play a key role in the development and recurrence of urinary tract infections.
Advances in molecular diagnostic techniques have confirmed that the urinary tract is not sterile but has its own dynamically changing microbiome closely interconnected with the gut and vaginal microbiota. Disruption of this microbial balance may facilitate colonization by uropathogenic bacteria and contribute to infection recurrence.
These insights have led to increased interest in antibiotic sparing preventive strategies. Oral immunomodulation based on Escherichia coli lysates enhances mucosal immune defense mechanisms of the urinary tract without exerting direct antibacterial effects or compromising microbiome integrity. Clinical studies and meta-analyses have shown that this approach reduces the frequency of recurrent urinary tract infections and decreases the need for antibiotic therapy. The aim of this review is to summarize the role of the microbiome in the pathogenesis of recurrent urinary tract infections and to highlight the importance of immunomodulation.