与年龄相仿的对照组相比，混合性尿失禁女性的泌尿微生物群。
The urinary microbiome in women with mixed urinary incontinence compared to similarly aged controls.
作者信息
Komesu Yuko M, Richter Holly E, Carper Benjamin, Dinwiddie Darrell L, Lukacz Emily S, Siddiqui Nazema Y, Sung Vivian W, Zyczynski Halina M, Ridgeway Beri, Rogers Rebecca G, Arya Lily A, Mazloomdoost Donna, Gantz Marie G
机构信息
Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC 10 5580 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.
出版信息
Int Urogynecol J. 2018 Dec;29(12):1785-1795. doi: 10.1007/s00192-018-3683-6. Epub 2018 Jun 16.
INTRODUCTION & HYPOTHESIS: Previous studies have suggested that women with urinary incontinence have an altered urinary microbiome. We hypothesized that the microbiome in women with mixed urinary incontinence (MUI) differed from controls and tested this hypothesis using bacterial gene sequencing techniques.
METHODS
This multicenter study compared the urinary microbiome in women with MUI and similarly aged controls. Catheterized urine samples were obtained; v4-6 regions of the 16S rRNA gene were sequenced to identify bacteria. Bacterial predominance (> 50% of an individual's genera) was compared between MUI and controls. Bacterial sequences were categorized into "community types" using Dirichlet multinomial mixture (DMM) methods. Generalized linear mixed models predicted MUI/control status based on clinical characteristics and community type. Post-hoc analyses were performed in women < 51 and ≥ 51 years. Sample size estimates required 200 samples to detect a 20% difference in Lactobacillus predominance with P < 0.05.
RESULTS
Of 212 samples, 97.6% were analyzed (123 MUI/84 controls, mean age 53 ± 11 years). Overall Lactobacillus predominance did not differ between MUI and controls (45/123 = 36.6% vs. 36/84 = 42.9%, P = 0.36). DMM analyses revealed six community types; communities differed by age (P = 0.001). A High-Lactobacillus (89.2% Lactobacillus) community had a greater proportion of controls (19/84 = 22.6%, MUI 11/123 = 8.9%). Overall, bacterial community types did not differ in MUI and controls. However, post-hoc analysis of women < 51 years found that bacterial community types distinguished MUI from controls (P = 0.041); Moderate-Lactobacillus (aOR 7.78, CI 1.85-32.62) and Mixed (aOR 7.10, CI 1.32-38.10) community types were associated with MUI. Community types did not differentiate MUI and controls in women ≥ 51 years (P = 0.94).
CONCLUSIONS
Women with MUI and controls did not differ in overall Lactobacillus predominance. In younger women, urinary bacterial community types differentiated MUI from controls.
引言与假设
既往研究表明，尿失禁女性的泌尿微生物群发生了改变。我们假设混合性尿失禁（MUI）女性的微生物群与对照组不同，并使用细菌基因测序技术检验了这一假设。
方法
这项多中心研究比较了MUI女性和年龄相仿的对照组的泌尿微生物群。获取导尿尿液样本；对16S rRNA基因的v4 - 6区域进行测序以鉴定细菌。比较MUI组和对照组之间的细菌优势菌（占个体菌属的> 50%）。使用狄利克雷多项混合（DMM）方法将细菌序列分类为“群落类型”。基于临床特征和群落类型，采用广义线性混合模型预测MUI/对照状态。对年龄< 51岁和≥51岁的女性进行事后分析。样本量估计需要200个样本才能检测出乳酸杆菌优势菌有20%的差异，P < 0.05。
结果
在212个样本中，97.6%进行了分析（123例MUI/84例对照，平均年龄53±11岁）。总体而言，MUI组和对照组的乳酸杆菌优势菌无差异（45/123 = 36.6% vs. 36/84 = 42.9%，P = 0.36）。DMM分析揭示了六种群落类型；群落类型因年龄而异（P = 0.001）。高乳酸杆菌群落（乳酸杆菌占89.2%）中对照组的比例更高（19/84 = 22.6%，MUI组为11/123 = 8.9%）。总体而言，MUI组和对照组的细菌群落类型无差异。然而，对年龄< 51岁女性的事后分析发现，细菌群落类型可区分MUI组和对照组（P = 0.041）；中度乳酸杆菌群落类型（调整优势比[aOR] 7.78，置信区间[CI] 1.85 - 32.62）和混合群落类型（aOR 7.10，CI 1.32 - 38.10）与MUI相关。在年龄≥51岁的女性中，群落类型不能区分MUI组和对照组（P = 0.94）。
结论
MUI女性和对照组在总体乳酸杆菌优势菌方面无差异。在年轻女性中，泌尿细菌群落类型可区分MUI组和对照组。
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