{
  "abstract": "Urinary tract infection (UTI) remains the most common infectious complication among individuals with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury or disease (SCI/D). Despite widespread reliance on microbiological and symptom-based criteria for UTI diagnosis, significant ambiguity persists—especially in distinguishing clinically meaningful change from normal variability in urinary analysis results. This uncertainty contributes to overdiagnosis, inappropriate antibiotic use, and antimicrobial resistance. The present study sought to operationalize “normal variability” of the urinary microbiome (urobiome) among adults with NLUTD due to SCI/D. Using repeated samples collected from asymptomatic individuals over time, we analyzed inter- and intra-individual microbial composition to determine stability and fluctuation under baseline conditions. We observed wide intra- and inter-individual variability, substantial overlap between asymptomatic and pre-symptomatic states, and a consistent predominance of genera conventionally labeled as “uropathogens” including Escherichia/Shigella, Klebsiella, Enterococcus, Staphylococcus, and Streptococcus, even in the absence of symptoms. Bray-Curtis dissimilarities between paired samples ranged from 0 to 1, confirming substantial within-person compositional change over time. These findings suggest that assumptions drawn from cross-sectional studies—linking particular taxa or diversity values to health or disease—are not supported within individuals over time, at least in people with NLUTD due to SCI/D. Empirically characterizing normal within-person variability is a prerequisite both for interpreting urobiome results in this high-risk population and for improving the accuracy and stewardship of UTI diagnosis and treatment.",
  "abstract_shown": true,
  "affiliations": [
    "Collaborative for Research on Outcomes and -Metrics, Georgetown University, Washington, District of Columbia, United States of America.",
    "Departments of Neurology, Rehabilitation Medicine, and Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, District of Columbia, United States of America.",
    "MedStar National Rehabilitation Hospital, Washington, District of Columbia, United States of America.",
    "MedStar Georgetown University Hospital, Washington, District of Columbia, United States of America.",
    "Department of Microbiology and Immunology, Loyola University Chicago, Maywood, Illinois, United States of America.",
    "Department of Medicine, Loyola University, Chicago, Illinois, United States of America."
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Rochelle E Tractenberg",
      "orcid": "0000-0002-1121-2119"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Suzanne L Groah"
    },
    {
      "affs": [
        0
      ],
      "name": "Ethan Newcomb"
    },
    {
      "affs": [
        4
      ],
      "name": "Mark Khemmani"
    },
    {
      "affs": [
        5
      ],
      "name": "Cara Joyce"
    },
    {
      "affs": [
        4
      ],
      "name": "Alan J Wolfe",
      "orcid": "0000-0003-4532-0545"
    },
    {
      "affs": [
        2
      ],
      "name": "Christopher R Riegner",
      "orcid": "0000-0001-9639-921X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cz19efsa0dt1d.bib",
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  "doi": "10.1371/journal.pone.0356391",
  "fulltext_url": "https://europepmc.org/articles/PMC13722290",
  "id": "cz19efsa0dt1d",
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    "1932-6203"
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  "landing_url": "https://doi.org/10.1371/journal.pone.0356391",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Anatomy"
    ],
    [
      "heading",
      "Antibiotics"
    ],
    [
      "heading",
      "Antimicrobials"
    ],
    [
      "heading",
      "Biochemistry"
    ],
    [
      "heading",
      "Biology and Life Sciences"
    ],
    [
      "heading",
      "Biology and life sciences"
    ],
    [
      "heading",
      "Body Fluids"
    ],
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      "heading",
      "Catheterization"
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    [
      "heading",
      "Cell biology"
    ],
    [
      "heading",
      "Cellular structures and organelles"
    ],
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      "heading",
      "Critical Care and Emergency Medicine"
    ],
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      "heading",
      "DNA sequencing"
    ],
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      "heading",
      "Ecological Metrics"
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      "heading",
      "Ecology"
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      "heading",
      "Ecology and Environmental Sciences"
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      "heading",
      "Gene Sequencing"
    ],
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      "heading",
      "Medicine and Health Sciences"
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      "heading",
      "Microbial Control"
    ],
    [
      "heading",
      "Microbiology"
    ],
    [
      "heading",
      "Molecular biology"
    ],
    [
      "heading",
      "Molecular biology techniques"
    ],
    [
      "heading",
      "Neurology"
    ],
    [
      "heading",
      "Neurotrauma"
    ],
    [
      "heading",
      "Non-coding RNA"
    ],
    [
      "heading",
      "Nucleic acids"
    ],
    [
      "heading",
      "Pharmacology"
    ],
    [
      "heading",
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    [
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    [
      "heading",
      "Ribosomal RNA"
    ],
    [
      "heading",
      "Ribosomes"
    ],
    [
      "heading",
      "Sequencing techniques"
    ],
    [
      "heading",
      "Shannon Index"
    ],
    [
      "heading",
      "Simpson Index"
    ],
    [
      "heading",
      "Species Diversity"
    ],
    [
      "heading",
      "Spinal Cord Injury"
    ],
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      "heading",
      "Surgical and Invasive Medical Procedures"
    ],
    [
      "heading",
      "Trauma Medicine"
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    [
      "heading",
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      "heading",
      "Urine"
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      "plos",
      "/Biology and life sciences/Anatomy/Body fluids/Urine"
    ],
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      "plos",
      "/Biology and life sciences/Biochemistry/Nucleic acids/RNA/Non-coding RNA/Ribosomal RNA"
    ],
    [
      "plos",
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    ],
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      "plos",
      "/Biology and life sciences/Cell biology/Cellular structures and organelles/Ribosomes/Ribosomal RNA"
    ],
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      "plos",
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    ],
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    ],
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      "plos",
      "/Biology and life sciences/Microbiology/Microbial control/Antimicrobials/Antibiotics"
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      "/Biology and life sciences/Molecular biology/Molecular biology techniques/Sequencing techniques/DNA sequencing/Gene sequencing"
    ],
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      "/Biology and life sciences/Physiology/Body fluids/Urine"
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    [
      "plos",
      "/Ecology and environmental sciences/Ecology/Ecological metrics/Species diversity/Shannon index"
    ],
    [
      "plos",
      "/Ecology and environmental sciences/Ecology/Ecological metrics/Species diversity/Simpson index"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Body fluids/Urine"
    ],
    [
      "plos",
      "/Medicine and health sciences/Critical care and emergency medicine/Trauma medicine/Traumatic injury/Neurotrauma/Spinal cord injury"
    ],
    [
      "plos",
      "/Medicine and health sciences/Neurology/Spinal cord injury"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pharmacology/Drugs/Antimicrobials/Antibiotics"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Catheterization"
    ],
    [
      "plos",
      "/Research and analysis methods/Molecular biology techniques/Sequencing techniques/DNA sequencing/Gene sequencing"
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  "pdf_url": "https://europepmc.org/articles/PMC13722290?pdf=render",
  "pmcid": "PMC13722290",
  "pmid": "42961986",
  "published": "2026-10-30",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/cz19efsa0dt1d.ris",
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      "url": "https://doi.org/10.1371/journal.pone.0356391"
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  "subjects": [
    {
      "field": "biochemistry",
      "origin": "heading:Molecular biology",
      "subfield": "molecular-biology"
    },
    {
      "field": "biology",
      "origin": "heading:Cell biology",
      "subfield": "cell-biology"
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    {
      "field": "biology",
      "origin": "plos:ecology",
      "subfield": "ecology"
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    {
      "field": "biology",
      "origin": "heading:Microbiology",
      "subfield": "microbiology"
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    {
      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
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  ],
  "title": "Variation in urobiome composition over time in asymptomatic individuals with spinal cord injury and disease using intermittent catheterization",
  "title_text": "Variation in urobiome composition over time in asymptomatic individuals with spinal cord injury and disease using intermittent catheterization",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:49Z",
  "url": "https://research.draconitic.com/paper/cz19efsa0dt1d",
  "venue": "PLOS One",
  "versions": []
}