Exploring Pathogen Factors Contributing to Urinary Tract Infections and Recurrence in Peri and Postmenopausal Women

Urinary tract infections are among the most common infections in women, with increased incidence and recurrence observed in peri and postmenopausal age groups. This study aims to explore bacterial factors that contribute to the onset and recurrence of UTIs in women aged 45 to 65 years. The focus is on understanding the clinical, microbiological, and molecular characteristics of uropathogens, particularly uropathogenic Escherichia coli. The study includes clinical analysis of urine samples for standard parameters and correlation of findings with patient symptoms. Isolated UPEC strains will undergo molecular typing using ERIC PCR to determine clonal patterns, and selected recurrent isolates will be further analyzed by whole genome sequencing to identify resistance genes, virulence factors, and persistence traits. In addition, the study will investigate the presence of persisters among UPEC strains and test the efficacy of antibiotics and potential anti persister agents using time kill assays. To capture the broader microbial landscape, fresh catheter urine samples will be subjected to shotgun metagenomic sequencing to identify uncultured and fastidious organisms that may contribute to infection. This multidisciplinary approach integrates clinical data, molecular microbiology, and metagenomics to improve the understanding of pathogen behavior in UTIs and recurrent infections. The findings are expected to inform more accurate diagnostics, appropriate pyuria cutoff values, and therapeutic strategies in managing UTIs among elderly women.