Available online 19 September 2022, 102636

Urinary tract infections (UTIs) features caused by anaerobic bacteria are reviewed.

Anaerobic bacteria are detected in both UTIs and urinary microbiota.

Some fastidious pathogens require urine culture under anaerobic atmosphere (UCAA).

Genomic, proteomic, and culturomic approaches were used.

Multiple treatments were frequently required.

Urinary tract infections (UTI) caused by anaerobic bacteria have scarcely been reported. Since anaerobic bacteria are commensals of the genitourinary tract, their presence in a urine sample adds ambiguity in making a definitive diagnosis of anaerobic UTI. It is well known that standard urine culture is the gold standard method for detection, identification, and antimicrobial susceptibility testing of the uropathogens. Nonetheless, both the difficulties in establishing them as pathogens and the scarcity of reported anaerobic UTI cases led to the discontinuation of routine urine culture under an anaerobic atmosphere (UCAA). On the other hand, it is important to emphasize that cuture-independent methods, such as proteomics and molecular technics, may detect anaerobes directly on a urine sample. Anaerobes are not included in guidelines for diagnosis and management of UTIs. At the same time, as fastidious uropathogens and antibiotic resistance become more common, accurate pathogen identification becomes even more important for effective UTI treatment. As a result, we conducted a review of the clinical context, pathogen antimicrobial susceptibility, and treatment of patients with anaerobic UTI. Because UCAA is a contentious topic, we narrowed our search to cases with both negative standard urine culture and positive UCAA.

Anaerobic urinary tract infection

Anaerobic bacteria

Molecular methods

MALDI-TOF MS used Directly in urine

Antimicrobial susceptibility testing

Treatment

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