Intracellular Bacterial Communities: A Potential Etiology for Chronic Lower Urinary Tract Symptoms

Urology. 2015 Sep;86(3):425-31. doi: 10.1016/j.urology.2015.04.002. Epub 2015 Jul 15.


Patients with persistent lower urinary tract symptoms and negative urine cultures are often difficult to treat. Infection may go undetected in these patients because the concentrations of bacteria in their urine are beneath the threshold of standard urine culture techniques. Empiric treatment may result in temporary relief, followed by recurrent symptoms. Occult and recurrent urinary tract infection may be due to both invasion of the bladder wall by uropathogenic Escherichia coli and the formation of biofilm-like intracellular bacterial communities. This review examines emerging evidence for a role of intracellular bacterial communities in human infection.

Publication types

  • Review

MeSH terms

  • Bacterial Adhesion / physiology*
  • Bacterial Infections / complications*
  • Bacterial Infections / diagnosis
  • Bacterial Load
  • Chronic Disease
  • Female
  • Humans
  • Lower Urinary Tract Symptoms / microbiology*
  • Male
  • Recurrence
  • Urinary Tract Infections / complications*
  • Urinary Tract Infections / diagnosis
  • Urothelium / microbiology*