Nicu-Canareica Oana, Bolocan Vlad-Octavian, Manolescu Loredana Sabina Cornelia, Armean Petru, Medar Cosmin, Burlibașa Liliana, Băean Maria-Luiza, Jinga Viorel
Doctoral Program Studies, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
Department of Fundamental Sciences, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania.
Pharmaceuticals (Basel). 2025 Jul 12;18(7):1038. doi: 10.3390/ph18071038.
The discovery of a resident urinary microbiome has significantly altered the understanding of urolithiasis, expanding its etiology beyond metabolic and dietary factors to include microbial contributions. This review highlights how specific uropathogens-particularly , , and -facilitate stone formation through mechanisms such as urease activity, citrate degradation, urine alkalinization, biofilm development, and inflammatory signaling. We critically examine how antibiotic therapies, while essential for treating urinary tract infections (UTIs), disrupt microbial homeostasis by depleting beneficial taxa like and enabling colonization by lithogenic and resistant strains. Recurrent or broad-spectrum antibiotic use is linked to persistent dysbiosis and increased risk of stone recurrence. Additionally, this paper explores emerging microbiome-targeted strategies-such as probiotics, prebiotics, bacteriotherapy, and precision antimicrobials-as potential interventions to restore microbial balance and mitigate stone risk. Recognizing the urinary microbiome as a therapeutic target opens new avenues for personalized, microbiota-conscious strategies in the prevention and management of kidney stone disease.
常驻泌尿微生物群的发现显著改变了对尿石症的认识，将其病因从代谢和饮食因素扩展到包括微生物的作用。本综述强调了特定的尿路病原体——特别是 、 和 ——如何通过脲酶活性、柠檬酸盐降解、尿液碱化、生物膜形成和炎症信号传导等机制促进结石形成。我们批判性地研究了抗生素疗法虽然对治疗尿路感染（UTIs）至关重要，但如何通过消耗有益菌群（如 ）并使致石和耐药菌株定植来破坏微生物稳态。反复或广泛使用抗生素与持续的生态失调和结石复发风险增加有关。此外，本文探讨了新兴的以微生物群为靶点的策略——如益生菌、益生元、细菌疗法和精准抗菌药物——作为恢复微生物平衡和降低结石风险的潜在干预措施。将泌尿微生物群视为治疗靶点为肾结石疾病的预防和管理中个性化的、关注微生物群的策略开辟了新途径。
