Gut microbiome correlates of recurrent urinary tract infection: a longitudinal, multi-center study

作者：JooHee Choi, Robert Thänert, Kimberly A. Reske, Katelin B. Nickel, Margaret A. Olsen, Tiffany Hink, Anna Thänert, Meghan A. Wallace, Bin Wang, Candice Cass, Margaret H. Barlet, Emily Struttmann, Zainab Hassan Iqbal, Steven R. Sax, Victoria J. Fraser, Arthur W. Baker, Katherine Foy, Brett Williams, Ben Xu, Pam Capocci-Tolomeo, Ebbing Lautenbach, Carey‐Ann D. Burnham, Erik R. Dubberke, Gautam Dantas, Jennie H. Kwon · 发表于：EClinicalMedicine · 年份：2024 · DOI：10.1016/j.eclinm.2024.102490 · 被引用次数：31 · 研究领域：Urinary Tract Infections Management、Gut microbiota and health、Reproductive tract infections research

Background Urinary tract infections (UTI) affect approximately 250 million people annually worldwide. Patients often experience a cycle of antimicrobial treatment and recurrent UTI (rUTI) that is thought to be facilitated by a gut reservoir of uropathogenic Escherichia coli (UPEC). Methods 125 patients with UTI caused by an antibiotic-resistant organism (ARO) were enrolled from July 2016 to May 2019 in a longitudinal, multi-center cohort study. Multivariate statistical models were used to assess the relationship between uropathogen colonization and recurrent UTI (rUTI), controlling for clinical characteristics. 644 stool samples and 895 UPEC isolates were interrogated for taxonomic composition, antimicrobial resistance genes, and phenotypic resistance. Cohort UTI gut microbiome profiles were compared against published healthy and UTI reference microbiomes, as well as assessed within-cohort for timepoint- and recurrence-specific differences. Findings Risk of rUTI was not independently associated with clinical characteristics. The UTI gut microbiome was distinct from healthy reference microbiomes in both taxonomic composition and antimicrobial resistance gene (ARG) burden, with 11 differentially abundant taxa at the genus level. rUTI and non-rUTI gut microbiomes in the cohort did not generally differ, but gut microbiomes from urinary tract colonized patients were elevated in E. coli abundance 7–14 days post-antimicrobial treatment. Corresponding UPEC gut isolates from urinary t...