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应用多种技术深入了解肾移植受者复杂的泌尿道微生物群落

Application of Various Techniques to Gain Insights Into the Complex Urinary Tract Microbial Communities of Renal Transplant Recipients.

作者信息

Sathiananthamoorthy Sanchutha, Florman Katia, Richard Damien, Cheng Ka Kei, Torri Vittoria, McCaig Fiona, Harber Mark, Rohn Jennifer L

机构信息

Department of Renal Medicine, Division of Medicine, Centre for Urological Biology, University College London, Royal Free Hospital Campus, London, United Kingdom.

Renal Unit, Department of Renal Medicine, Division of Medicine, University College London, Royal Free Hospital, London, United Kingdom.

出版信息

Transplant Direct. 2023 Jan 6;9(2):e1418. doi: 10.1097/TXD.0000000000001418. eCollection 2023 Feb.

DOI:10.1097/TXD.0000000000001418
PMID:36700061
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9820791/
Abstract

UNLABELLED

Urinary tract infections (UTIs) are prevalent in renal transplant (RT) recipients and associated with worse outcomes. Early detection by sensitive diagnostic tests and appropriate treatment strategies in this cohort is therefore crucial, but evidence has shown that current methods may miss genuine infections. Research has shed light on the urinary tract microbial ecology of healthy individuals and nontransplant patients with UTI, but information on the RTx cohort is scant. We conducted a cross-sectional study to (i) compare the gold standard diagnostic culture with alternative techniques and (ii) characterize RTx patient urinary microbial communities.

METHODS

Midstream urine specimens were collected from 51 RTx patients attending a renal transplant clinic and 27 asymptomatic controls. Urinary microscopy, dipstick, and routine culture were performed. To improve sensitivity of microbial detection, we cultured the urinary cell sediment and performed 16S rRNA gene sequencing on urine. Uroplakin-positive urothelial cells shed in urine were analyzed by immunofluorescence staining for any bacterial association.

RESULTS

Sediment culture and 16S rRNA sequencing confirmed detection deficiencies of diagnostic culture and revealed differences in the urobiomes of RTx patients and controls. Specifically, , , and were most abundant in patients, whereas , , and were most abundant in controls. The application of both culture and sequencing provided a more nuanced view of the urinary microbial communities.

CONCLUSIONS

This study provides insight into the potential problems of diagnostic culture within RTx patients and sheds light on their urinary microbial inhabitants. Further work may identify key microbial signatures and facilitate the development of better tools for UTI detection within this cohort, which could allow targeted intervention before an infection leads to serious consequences. http://links.lww.com/TXD/A479.

摘要

未标注

尿路感染（UTIs）在肾移植（RT）受者中很常见，且与较差的预后相关。因此，通过敏感的诊断测试进行早期检测以及在该队列中采取适当的治疗策略至关重要，但有证据表明，目前的方法可能会遗漏真正的感染。研究已经揭示了健康个体和非移植性UTI患者的尿路微生物生态学，但关于肾移植队列的信息却很少。我们进行了一项横断面研究，以（i）将金标准诊断培养与替代技术进行比较，以及（ii）对肾移植患者的尿液微生物群落进行特征分析。

方法

从51名前往肾移植诊所就诊的肾移植患者和27名无症状对照者中收集中段尿标本。进行尿液显微镜检查、试纸检测和常规培养。为提高微生物检测的敏感性，我们对尿液细胞沉淀物进行培养，并对尿液进行16S rRNA基因测序。通过免疫荧光染色分析尿液中脱落的uroplakin阳性尿路上皮细胞与任何细菌的关联。

结果

沉淀物培养和16S rRNA测序证实了诊断培养的检测缺陷，并揭示了肾移植患者和对照者尿微生物群的差异。具体而言，[此处原文缺失具体菌种信息]在患者中最为丰富，而[此处原文缺失具体菌种信息]在对照者中最为丰富。培养和测序的应用提供了对尿液微生物群落更细致入微的看法。

结论

本研究深入了解了肾移植患者诊断培养中潜在的问题，并揭示了他们尿液中的微生物群落。进一步的工作可能会识别关键的微生物特征，并有助于开发更好的工具来检测该队列中的UTI，这可以在感染导致严重后果之前进行有针对性的干预。http://links.lww.com/TXD/A479

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Sci Rep. 2022 Feb 17;12(1):2698. doi: 10.1038/s41598-022-06646-1.
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