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Liu H, Wei Y, Xu Z, Lin H, Zhao Y, Wang S, Gao F, Feng N, Wolfe AJ, Liu F. Exploring Factors Affecting Acceptance of Fecal Microbiota Transplantation for Patients with Recurrent Urinary Tract Infections: a Descriptive Qualitative Study. Patient Prefer Adherence 2024; 18:1257-1269. [PMID: 38911589 PMCID: PMC11192636 DOI: 10.2147/ppa.s452328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/23/2024] [Indexed: 06/25/2024] Open
Abstract
Purpose Patients with recurrent urinary tract infections face complex management challenges. Fecal microbiota transplantation is a superior treatment for chronic infectious diseases, but limited patient knowledge affects treatment decisions. This study aims to identify factors associated with hesitancy towards fecal microbiota transplantation among patients with recurrent urinary tract infections, to help physicians and nurses in providing accurate and useful information to patients. Patients and Methods A descriptive qualitative approach was employed, utilizing semi-structured interviews conducted with patients experiencing recurrent urinary tract infections who expressed hesitancy towards fecal microbiota transplantation. The interviews took place between September 2021 and December 2022. Thematic analysis was conducted on the semi-structured interviews to identify perceived facilitators and barriers associated with fecal microbiota transplantation. Results The analysis included interviews with thirty adult female patients with recurrent urinary tract infections. Four facilitators influencing patients' decision-making regarding fecal microbiota transplantation were identified: (1) the motivating role of hope and expectations for active patient participation; (2) the influence of healthcare providers, as well as family members and friends on patients' decisions to pursue fecal microbiota transplantation; (3) the patients' perception of fecal microbiota transplantation as a low-risk treatment option; and (4) the dedication to the advancement of medical treatments. In contrast, two primary barriers to accepting fecal microbiota transplantation were identified: (1) that conventional treatment controls disease activity, while fecal microbiota transplantation effects remain uncertain; and (2) that safety concerns surrounding fecal microbiota transplantation. Conclusion Comprehensive information about fecal microbiota transplantation, including donor selection, sample processing, the procedure, and potential discomfort, is essential for patients and families to make informed treatment decisions. Registration CHiCTR2100048970.
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Affiliation(s)
- Hongyuan Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Yaodi Wei
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Zhenyi Xu
- Department of Urology, Affiliated Wuxi No. 2 Hospital, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Hao Lin
- Department of Urology, Affiliated Wuxi No. 2 Hospital, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Yu Zhao
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Shiyu Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Fengbao Gao
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
| | - Ninghan Feng
- Department of Urology, Affiliated Wuxi No. 2 Hospital, Nanjing Medical University, Wuxi, People’s Republic of China
| | - Alan J Wolfe
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Fengping Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi, People’s Republic of China
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2
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Chai TC, Wolfe AJ, Brubaker L. The Urinary Microbiome: Improving Diagnostics and Management of Urinary Tract Infections in Adult Females. Infect Dis Clin North Am 2024; 38:241-253. [PMID: 38729665 DOI: 10.1016/j.idc.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
This article discusses the urinary microbiome in relation to urinary tract infection (UTI) in women. It makes biologic sense that the microbiota of different niches (bladder, vagina, and gut) interact with each other in health, as well as during a UTI event; however, these relationships remain poorly understood. Future research should close knowledge gaps regarding the interactions between the urinary microbiota and the host, amongst the microbiota of adjacent niches, and between the microbes within the same microbiota. The new knowledge should result in improved UTI treatment in the age of antibiotic stewardship.
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Affiliation(s)
- Toby C Chai
- Department of Urology, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, 725 Albany Street, Suite 3B, Boston, MA 02118, USA.
| | - Alan J Wolfe
- Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, 2160 South First Avenue, Building 115, Room 215, Maywood, IL 60153, USA
| | - Linda Brubaker
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Urogynecology and Reconstructive Pelvic Surgery, University of California, 9300 Campus Point, Mail Code 7433, La Jolla, CA 92037-7433, USA
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3
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Urakami C, Yamanouchi S, Kimata T, Tsuji S, Akagawa S, Kino J, Akagawa Y, Kato S, Araki A, Kaneko K. Abnormal Development of Microbiota May Be a Risk Factor for Febrile Urinary Tract Infection in Infancy. Microorganisms 2023; 11:2574. [PMID: 37894232 PMCID: PMC10609410 DOI: 10.3390/microorganisms11102574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Febrile urinary tract infection (fUTI) is common in infants, but specific risk factors for developing it remain unclear. As most fUTIs are caused by ascending infections of intestinal bacteria, dysbiosis-an imbalance in gut microbial communities-may increase fUTI risk. This study was conducted to test the hypothesis that abnormal development of gut microbiota during infancy increases the risk of developing fUTI. Stool samples were collected from 28 infants aged 3-11 months with first-onset fUTI (fUTI group) and 51 healthy infants of the same age (HC group). After bacterial DNA extraction, 16S rRNA expression was measured and the diversity of gut microbiota and constituent bacteria were compared between the two groups. The alpha diversity of gut microbiota (median Shannon index and Chao index) was significantly lower in the fUTI group (3.0 and 42.5) than in the HC group (3.7 and 97.0; p < 0.001). The beta diversity also formed different clusters between the two groups (p < 0.001), suggesting differences in their microbial composition. The linear discriminant analysis effect size showed that the fUTI group proportionally featured significantly more Escherichia-Shigella in the gut microbiota (9.5%) than the HC group (3.1%; p < 0.001). In summary, abnormal gut microbiota development during infancy may increase the risk of fUTI.
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Affiliation(s)
- Chika Urakami
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
- Osaka Asahi Children’s Hospital, Osaka 535-0022, Japan; (J.K.); (A.A.)
| | - Sohsaku Yamanouchi
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
| | - Takahisa Kimata
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
| | - Shoji Tsuji
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
| | - Shohei Akagawa
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
| | - Jiro Kino
- Osaka Asahi Children’s Hospital, Osaka 535-0022, Japan; (J.K.); (A.A.)
| | - Yuko Akagawa
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
| | - Shogo Kato
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
| | - Atsushi Araki
- Osaka Asahi Children’s Hospital, Osaka 535-0022, Japan; (J.K.); (A.A.)
| | - Kazunari Kaneko
- Department of Pediatrics, Kansai Medical University, Osaka 573-1010, Japan; (C.U.); (S.Y.); (T.K.); (S.T.); (S.A.); (Y.A.); (S.K.)
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Wood N, Propst K, Yao M, Ferrando CA. Fecal Microbiota Transfer for Clostridium difficile Infection and Its Effects on Recurrent Urinary Tract Infection. UROGYNECOLOGY (PHILADELPHIA, PA.) 2023; 29:814-826. [PMID: 36946907 DOI: 10.1097/spv.0000000000001350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
IMPORTANCE Recurrent urinary tract infection (rUTI) poses a significant management challenge, and fecal microbiota transfer (FMT) has been shown in a limited manner to positively effect rUTI. OBJECTIVES The objective of this study was to compare UTI rates after FMT for Clostridium difficile infection (CDI) in patients with previously diagnosed rUTI and patients without a previous diagnosis of rUTI. STUDY DESIGN This was a retrospective cohort study of female patients who underwent FMT between 2015 and 2020 and were identified from a database at a tertiary care referral center. The electronic medical record was queried for demographic and UTI characteristics in the 3 years before and 5 years after FMT, which were compared between patients with or without a preexisting history of rUTI. RESULTS One hundred thirty-five patients were included, 17 of whom had a preexisting history of rUTI. The median number of culture-proven UTIs was 1 in the rUTI group versus 0 in the non-rUTI group both in the 1 year ( P = 0.003) and 3 years ( P < 0.001) before FMT. Most UTIs before and after FMT were Escherichia coli UTIs (53.8%) and carried some antibiotic resistance (54.6%). Comparatively, in the year after FMT, there were no differences between groups in UTI frequency or antibiotic administration (0 [0-1] vs 0.5 [0-1], P = 0.28). A trend toward decreased frequency of UTI in the 1 year after FMT was seen in the rUTI group. On survival analysis, there was a nonsignificant decrease in the 3-year UTI-free rate for the rUTI group compared with the non-rUTI group (76.5% vs 90.1%, P = 0.07). CONCLUSIONS Patients with recurrent UTI undergoing FMT for recurrent CDI experienced a trend toward a decrease in frequency of UTI after FMT.
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Affiliation(s)
- Nicole Wood
- From the Women's Health Institute, Department of OBGYN, Cleveland Clinic Foundation, Cleveland, OH
| | - Katie Propst
- Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Meng Yao
- Department of Quantitative Health Sciences
| | - Cecile A Ferrando
- Women's Health Institute, Department of FPMRS, Cleveland Clinic Foundation, Cleveland, OH
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Roth RS, Liden M, Huttner A. The urobiome in men and women: a clinical review. Clin Microbiol Infect 2023; 29:1242-1248. [PMID: 36028087 DOI: 10.1016/j.cmi.2022.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Antibiotic therapy alone is unable to control recurrent urinary tract infection (UTI); uropathogens have become multiresistant, and alternative strategies are needed. Far from sterile, the urinary tract contains various low-biomass microbiota, some of whose members appear to protect against clinical UTI. OBJECTIVES This narrative review summarizes (a) the current knowledge of male and female urobiomes in healthy and diseased states, as well as their interplay among sexual partners and (b) clinical trials to date assessing probiotic and other nonantibiotic measures to reduce UTI. SOURCES We used the PubMed interface to search Ovid Medline for articles describing urogenital flora, UTI, UTI dysbiosis, the effects of sexual intercourse on urogenital flora, and clinical trials of probiotics as UTI prophylaxis. CONTENT The healthy urobiome of women contains several Lactobacillus species, some of which may impede Escherichia coli growth in the urinary tract. Although Lactobacilli have been found in male urethral microbiota, their presence in male bladder microbiota is less certain. Distal male urethral and vaginal microbiomes of male and sexual female partners influence one another, but more research is needed on the direct interplay of their full urobiomes. Clinical trials assessing the therapeutic potential of Lactobacilli have been largely underpowered and highly varied in tested formulations and routes and frequencies of administration; as such, they have failed to show a clear benefit. Faecal microbiota transplantation for recurrent Clostridium difficile infection was shown, in a retrospective study of seven patients, to reduce recurrent UTI as a side effect. IMPLICATIONS The urobiome in men and women is complex, variable, and still understudied. Although there is hope that Lactobacilli and faecal microbial transplantation could be future nonantibiotic options for recurrent UTI, both require more pharmacologic and clinical research to identify optimal preparations and routes of administration.
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Affiliation(s)
- Romain S Roth
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Mia Liden
- University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - Angela Huttner
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland; University of Geneva, Faculty of Medicine, Geneva, Switzerland; Center for Clinical Research, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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6
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Masenga SK, Povia JP, Lwiindi PC, Kirabo A. Recent Advances in Microbiota-Associated Metabolites in Heart Failure. Biomedicines 2023; 11:2313. [PMID: 37626809 PMCID: PMC10452327 DOI: 10.3390/biomedicines11082313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023] Open
Abstract
Heart failure is a risk factor for adverse events such as sudden cardiac arrest, liver and kidney failure and death. The gut microbiota and its metabolites are directly linked to the pathogenesis of heart failure. As emerging studies have increased in the literature on the role of specific gut microbiota metabolites in heart failure development, this review highlights and summarizes the current evidence and underlying mechanisms associated with the pathogenesis of heart failure. We found that gut microbiota-derived metabolites such as short chain fatty acids, bile acids, branched-chain amino acids, tryptophan and indole derivatives as well as trimethylamine-derived metabolite, trimethylamine N-oxide, play critical roles in promoting heart failure through various mechanisms. Mainly, they modulate complex signaling pathways such as nuclear factor kappa-light-chain-enhancer of activated B cells, Bcl-2 interacting protein 3, NLR Family Pyrin Domain Containing inflammasome, and Protein kinase RNA-like endoplasmic reticulum kinase. We have also highlighted the beneficial role of other gut metabolites in heart failure and other cardiovascular and metabolic diseases.
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Affiliation(s)
- Sepiso K. Masenga
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (J.P.P.); (P.C.L.)
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-6602, USA
| | - Joreen P. Povia
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (J.P.P.); (P.C.L.)
| | - Propheria C. Lwiindi
- HAND Research Group, School of Medicine and Health Sciences, Mulungushi University, Livingstone Campus, Livingstone 10101, Zambia; (J.P.P.); (P.C.L.)
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232-6602, USA
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7
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Mi F, Wang X, Zheng W, Wang J, Lin T, Sun M, Su M, Li H, Ye H. Effects of Different Preparation Methods on Microbiota Composition of Fecal Suspension. Mol Biotechnol 2023; 65:871-880. [PMID: 36315335 DOI: 10.1007/s12033-022-00590-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/20/2022] [Indexed: 05/23/2023]
Abstract
Fecal microbiota transplantation is an emerging disease-modifying therapy. The viability of the microbiome in feces and its successful transfer depends on the preparation of fecal microbiota suspension. However, currently, no standard operation procedure is proposed for fecal suspension preparation. This study aims to compare the effect of different preparation methods on the composition of fecal microbiota composition in the rat. Four methods were used to collect the fecal suspension from fresh rat fecal (Group A), including stirring with normal saline (Group B), stirring with normal saline and then standing (Group C), stirring with normal saline and filtered with gauze (Group D), and stirring with normal saline and centrifuged (Group E). 16S ribosomal RNA gene (16S rDNA) sequencing technology was used to analyze the microbiota diversity and composition of each group of samples. Compared with fresh feces, the bacterial richness of the fecal suspension obtained by the four methods was significantly decreased (P < 0.05). The structural similarity with fresh fecal microbiota from high to low is groups B, D, C, and E. All four methods changed the microbiota structure to varying degrees, thus may affect the effect of FMT. In conclusion, choosing different methods to prepare fecal suspensions may help to better optimize the application of FMT.
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Affiliation(s)
- Fangxia Mi
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Xinxue Wang
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Wentao Zheng
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Jian Wang
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Tong Lin
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Mengxia Sun
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Mingli Su
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Hong Li
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China
| | - Hua Ye
- The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315046, Zhejiang, People's Republic of China.
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8
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Kim DS, Lee JW. Urinary Tract Infection and Microbiome. Diagnostics (Basel) 2023; 13:diagnostics13111921. [PMID: 37296773 DOI: 10.3390/diagnostics13111921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Urinary tract infection is one of the most common bacterial infections and can cause major burdens, not only to individuals but also to an entire society. Current knowledge of the microbial communities in the urinary tract has increased exponentially due to next-generation sequencing and expanded quantitative urine culture. We now acknowledge a dynamic urinary tract microbiome that we once thought was sterile. Taxonomic studies have identified the normal core microbiota of the urinary tract, and studies on the changes in microbiome due to sexuality and age have set the foundation for microbiome studies in pathologic states. Urinary tract infection is not only caused by invading uropathogenic bacteria but also by changes to the uromicrobiome milieu, and interactions with other microbial communities can also contribute. Recent studies have provided insights into the pathogenesis of recurrent urinary tract infections and antimicrobial resistance. New therapeutic options for urinary tract infections also show promise; however, further research is needed to fully understand the implications of the urinary microbiome in urinary tract infections.
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Affiliation(s)
- Dong Soo Kim
- Department of Urology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
| | - Jeong Woo Lee
- Department of Urology, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
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Pargin E, Roach MJ, Skye A, Papudeshi B, Inglis LK, Mallawaarachchi V, Grigson SR, Harker C, Edwards RA, Giles SK. The human gut virome: composition, colonization, interactions, and impacts on human health. Front Microbiol 2023; 14:963173. [PMID: 37293229 PMCID: PMC10244655 DOI: 10.3389/fmicb.2023.963173] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
The gut virome is an incredibly complex part of the gut ecosystem. Gut viruses play a role in many disease states, but it is unknown to what extent the gut virome impacts everyday human health. New experimental and bioinformatic approaches are required to address this knowledge gap. Gut virome colonization begins at birth and is considered unique and stable in adulthood. The stable virome is highly specific to each individual and is modulated by varying factors such as age, diet, disease state, and use of antibiotics. The gut virome primarily comprises bacteriophages, predominantly order Crassvirales, also referred to as crAss-like phages, in industrialized populations and other Caudoviricetes (formerly Caudovirales). The stability of the virome's regular constituents is disrupted by disease. Transferring the fecal microbiome, including its viruses, from a healthy individual can restore the functionality of the gut. It can alleviate symptoms of chronic illnesses such as colitis caused by Clostridiodes difficile. Investigation of the virome is a relatively novel field, with new genetic sequences being published at an increasing rate. A large percentage of unknown sequences, termed 'viral dark matter', is one of the significant challenges facing virologists and bioinformaticians. To address this challenge, strategies include mining publicly available viral datasets, untargeted metagenomic approaches, and utilizing cutting-edge bioinformatic tools to quantify and classify viral species. Here, we review the literature surrounding the gut virome, its establishment, its impact on human health, the methods used to investigate it, and the viral dark matter veiling our understanding of the gut virome.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Sarah K. Giles
- Flinders Accelerator for Microbiome Exploration, College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
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10
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Sturov NV, Popov SV, Zhukov VA, Lyapunova TV, Rusanova EI, Kobylyanu GN, Kobylyanu GN. Intestinal Microbiota Correction in the Treatment and Prevention of Urinary Tract Infection. Turk J Urol 2022; 48:406-414. [PMID: 36416330 PMCID: PMC9797784 DOI: 10.5152/tud.2022.22119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Intestinal microbiota is a topical subject of modern research. The maintenance of a healthy intestinal micro biota is an important component of homeostasis, and violations of its composition and functions, called dysbiosis, are associated with a number of diseases, including urinary tract infections. Antimicrobial therapy leads to significant changes in the intestinal microbiota and causes the possibility of urinary tract infection recurrence. In this regard, it is important to study methods of microbiota correction in order to restore its structural and functional integrity.
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Affiliation(s)
- Nikolay V. Sturov
- General Medical Practice Department, RUDN University (Peoples’ Friendship University of Russia), Moscow, Russian Federation
| | - Sergey V. Popov
- General Medical Practice Department, RUDN University (Peoples’ Friendship University of Russia), Moscow, Russian Federation
| | - Vladimir A. Zhukov
- General Medical Practice Department, RUDN University (Peoples’ Friendship University of Russia), Moscow, Russian Federation,Corresponding author:Vladimir A. ZhukovE-mail:
| | - Tatiana V. Lyapunova
- Medical Informatics and Telemedicine Department, RUDN University (Peoples’ Friendship University of Russia), Moscow, Russian Federation
| | - Ekaterina I. Rusanova
- General Medical Practice Department, RUDN University (Peoples’ Friendship University of Russia), Moscow, Russian Federation
| | - Georgy N. Kobylyanu
- General Medical Practice Department, RUDN University (Peoples’ Friendship University of Russia), Moscow, Russian Federation
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11
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Lu X, Liu J, Zhou B, Wang S, Liu Z, Mei F, Luo J, Cui Y. Microbial metabolites and heart failure: Friends or enemies? Front Microbiol 2022; 13:956516. [PMID: 36046023 PMCID: PMC9420987 DOI: 10.3389/fmicb.2022.956516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/19/2022] [Indexed: 12/12/2022] Open
Abstract
Heart failure (HF), a global health issue characterized by structural or functional cardiac dysfunction, which was found to be associated with the gut microbiome recently. Although multiple studies suggested that the gut microbiome may have an impact on the development of cardiovascular diseases, the underlying mechanism of the gut microbiome in HF remains unclear. The study of metabolites from gut microbiota influenced by dietary nutrition uptake suggested that gut microbiota may affect the process of HF. However, on the basis of the microbiota’s complicated roles and their interactions with metabolites, studies of microbial metabolites in HF had rarely been described so far. In this review, we focused on dietary nutrition-related factors that were involved in the development and progression of HF, such as trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids (BAs), to summarize their advances and several potential targets in HF. From a therapeutic standpoint, we discussed microbial metabolites as a potential strategy and their applications in HF as well.
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Affiliation(s)
- Xiaofeng Lu
- Department of Cardiovascular Surgery, Heart Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Jingjing Liu
- Department of Cardiovascular Surgery, Heart Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
- Bengbu Medical College, Bengbu, China
| | - Bing Zhou
- Department of Cardiovascular Surgery, Heart Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Shuwei Wang
- Department of Cardiovascular Surgery, Heart Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Zhifang Liu
- Department of Cardiovascular Surgery, Heart Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Fuyang Mei
- Department of Cardiovascular Surgery, Heart Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
| | - Junxiang Luo
- Department of Critical Care Medicine, Lishui Hospital of Traditional Chinese Medicine, Lishui, China
- Junxiang Luom,
| | - Yong Cui
- Department of Cardiovascular Surgery, Heart Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, China
- *Correspondence: Yong Cui,
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Vendrik KEW, de Meij TGJ, Bökenkamp A, Ooijevaar RE, Groenewegen B, Hendrickx APA, Terveer EM, Kuijper EJ, van Prehn J. Transmission of Antibiotic-Susceptible Escherichia coli Causing Urinary Tract Infections in a Fecal Microbiota Transplantation Recipient: Consequences for Donor Screening? Open Forum Infect Dis 2022; 9:ofac324. [PMID: 35899275 PMCID: PMC9314704 DOI: 10.1093/ofid/ofac324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022] Open
Abstract
Fecal microbiota transplantation (FMT) has been reported to decrease the incidence of recurrent urinary tract infections (UTIs), presumably by restoring microbiome diversity and/or uropathogen competition. We report a 16-year-old female with recurrent UTIs caused by multidrug-resistant Klebsiella pneumoniae, for which frequent intravenous broad-spectrum antibiotic treatment was necessary. The patient was treated with FMT from a well-screened healthy donor without multidrug-resistant bacteria in the feces. After FMT, she developed several UTIs with an antibiotic-susceptible Escherichia coli that could be treated orally. The uropathogenic E. coli could be cultured from donor feces, and whole genome sequencing confirmed donor-to-recipient transmission. Our observation should stimulate discussion on long-term follow-up of all infections after FMT and donor fecal screening for antibiotic-susceptible Enterobacterales.
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Affiliation(s)
- Karuna E W Vendrik
- Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Tim G J de Meij
- Department of Pediatrics, Amsterdam University Medical Centers, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Arend Bökenkamp
- Department of Pediatric Nephrology, Amsterdam Medical Centers, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Rogier E Ooijevaar
- Netherlands Donor Feces Bank, Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Bas Groenewegen
- Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Antoni P A Hendrickx
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Elisabeth M Terveer
- Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Ed J Kuijper
- Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Joffrey van Prehn
- Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
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Kenneally C, Murphy CP, Sleator RD, Culligan EP. The Urinary Microbiome and Biological Therapeutics: Novel Therapies For Urinary Tract Infections. Microbiol Res 2022; 259:127010. [DOI: 10.1016/j.micres.2022.127010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/12/2022]
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14
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Schiereck T, Yeldan S, Kranz J, Schneidewind L, Wagenlehner F, Wieters I, Vehreschild MJGT, Otto T, Barski D. [Urinary bladder microbiome analysis and probiotic treatment options for women with recurrent urinary tract infections]. Urologe A 2022; 61:41-51. [PMID: 34424357 PMCID: PMC8381347 DOI: 10.1007/s00120-021-01621-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
Novel preventive measures and therapeutic approaches are needed to reduce the frequency of recurrent urinary tract infections (rUTI) and the associated emergence of multidrug-resistant uropathogens. The aim of this review is to systematically present the available evidence on the urinary bladder microbiome of healthy women and those with rUTIs. In addition, relevant studies on the efficacy of probiotics in rUTIs are presented in a structured manner. This will provide an overview on the current state of research and an outlook on treatment strategies beyond the usual antimicrobial options.
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Affiliation(s)
- T Schiereck
- Urologische Klinik, Lukaskrankenhaus Neuss, Rheinland Klinikum, Preussenstr. 84, 41464, Neuss, Deutschland.
| | - S Yeldan
- Urologische Klinik, Lukaskrankenhaus Neuss, Rheinland Klinikum, Preussenstr. 84, 41464, Neuss, Deutschland
| | - J Kranz
- Klinik für Urologie und Kinderurologie, St.-Antonius-Hospital Eschweiler, Akademisches Lehrkrankenhaus der RWTH Aachen, Eschweiler, Deutschland
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - L Schneidewind
- Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18055, Rostock, Deutschland
| | - F Wagenlehner
- Klinik für Urologie, Kinderurologie und Andrologie, Universitätsklinikum Gießen, Gießen, Deutschland
| | - I Wieters
- Zentrum für Innere Medizin, Infektiologie, Universitätsklinikum Frankfurt, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
| | - M J G T Vehreschild
- Zentrum für Innere Medizin, Infektiologie, Universitätsklinikum Frankfurt, Goethe Universität Frankfurt, Frankfurt am Main, Deutschland
| | - T Otto
- Urologische Klinik, Lukaskrankenhaus Neuss, Rheinland Klinikum, Preussenstr. 84, 41464, Neuss, Deutschland
- Universität Duisburg-Essen, Essen, Deutschland
| | - D Barski
- Urologische Klinik, Lukaskrankenhaus Neuss, Rheinland Klinikum, Preussenstr. 84, 41464, Neuss, Deutschland
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15
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Ghani R, Mullish BH, Roberts LA, Davies FJ, Marchesi JR. The potential utility of fecal (or intestinal) microbiota transplantation in controlling infectious diseases. Gut Microbes 2022; 14:2038856. [PMID: 35230889 PMCID: PMC8890388 DOI: 10.1080/19490976.2022.2038856] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
The intestinal microbiota is recognized to play a role in the defense against infection, but conversely also acts as a reservoir for potentially pathogenic organisms. Disruption to the microbiome can increase the risk of invasive infection from these organisms; therefore, strategies to restore the composition of the gut microbiota are a potential strategy of key interest to mitigate this risk. Fecal (or Intestinal) Microbiota Transplantation (FMT/IMT), is the administration of minimally manipulated screened healthy donor stool to an affected recipient, and remains the major 'whole microbiome' therapeutic approach at present. Driven by the marked success of using FMT in the treatment of recurrent Clostridioides difficile infection, the potential use of FMT in treating other infectious diseases is an area of active research. In this review, we discuss key examples of this treatment based on recent findings relating to the interplay between microbiota and infection, and potential further exploitations of FMT/IMT.
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Affiliation(s)
- Rohma Ghani
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Benjamin H. Mullish
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Lauren A. Roberts
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Frances J. Davies
- MRC Centre for Molecular Bacteriology and Infection, Imperial College London, London, UK
| | - Julian R. Marchesi
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
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16
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The Role of Gut, Vaginal, and Urinary Microbiome in Urinary Tract Infections: From Bench to Bedside. Diagnostics (Basel) 2020; 11:diagnostics11010007. [PMID: 33375202 PMCID: PMC7822161 DOI: 10.3390/diagnostics11010007] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/18/2020] [Accepted: 12/19/2020] [Indexed: 12/16/2022] Open
Abstract
The current paradigm of urinary tract infection (UTI) pathogenesis takes into account the contamination of the periurethral space by specific uropathogens residing in the gut, which is followed by urethral colonization and pathogen ascension to the urinary bladder. Consequently, studying the relationship between gut microbiota and the subsequent development of bacteriuria and UTI represents an important field of research. However, the well-established diagnostic and therapeutic paradigm for urinary tract infections (UTIs) has come into question with the discovery of a multifaceted, symbiotic microbiome in the healthy urogenital tract. More specifically, emerging data suggest that vaginal dysbiosis may result in Escherichia coli colonization and prompt recurrent UTIs, while urinary microbiome perturbations may precede the development of UTIs and other pathologic conditions of the urinary system. The question is whether these findings can be exploited for risk reduction and treatment purposes. This review aimed to appraise the three aforementioned specific microbiomes regarding their potential influence on UTI development by focusing on the recent studies in the field and assessing the potential linkages between these different niches, as well as evaluating the state of translational research for novel therapeutic and preventative approaches.
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