Comparative analysis of urinary microbiome diversity in diabetic patients with and without suspected UTI

Abstract

Urinary tract infections (UTIs) represent one of the most common bacterial infections worldwide, imposing a considerable global health and economic burden. According to Hu et al. (2025), the incidence of UTIs among older women increased by 132% between 1990 and 2021, rising from 15.87 million to 36.77 million cases. In 2019 alone, UTIs accounted for approximately 404.61 million cases and 236,790 deaths globally. In light of these alarming trends, this study aims to address key gaps in microbial characterization of UTIs among diabetic patients. A cross-sectional survey was conducted involving both inpatient and outpatient participants, categorized into two groups: Group 1 (No UTI; patients with no clinical evidence of infection), and Group 2 (Suspected UTI; patients presenting clinical signs or symptoms suggestive of a UTI but not yet confirmed). The findings of this study provide compelling evidence that the clinical state of a suspected UTI in diabetic patients is defined by a profound ecological shift in the urinary microbiome, underscoring the complex interplay between host metabolic state and microbial community dynamics.