Role of the urobiome in urinary tract infections: current knowledge and research prospects

Urinary tract infections (UTIs), particularly cystitis, are among the most common bacterial infections worldwide, with a disproportionate burden on adult female individuals, who often have recurrence. The discovery of the urobiome, a low microbial biomass community in the urinary tract, has transformed our understanding of UTI pathogenesis and infection susceptibility. Experimental and omics approaches provide insights into the taxonomic and functional complexity of the urobiome, highlighting the importance of microbial metabolites, ecological interactions, and host-microbe dynamics. Polymicrobial interactions within the urobiome further modulate pathogenicity, with some microbes inhibiting or promoting uropathobionts. Advancing UTI management will require combining omics and experimental research with ecological and evolutionary insights. This approach can enable the development of personalised, non-antibiotic interventions, such as live biotherapeutics and prebiotics, to improve diagnostics, reduce antibiotic resistance, and enhance treatment efficacy.