From the Women's Health Institute, Department of OBGYN, Cleveland Clinic Foundation, Cleveland, OH.
Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL.
Urogynecology (Phila). 2023 Oct 1;29(10):814-826. doi: 10.1097/SPV.0000000000001350. Epub 2023 Mar 28.
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.
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.
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.
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).
Patients with recurrent UTI undergoing FMT for recurrent CDI experienced a trend toward a decrease in frequency of UTI after FMT.
复发性尿路感染（rUTI）是一个具有挑战性的管理难题，粪便微生物群转移（FMT）已被证明在一定程度上对 rUTI 有积极影响。
本研究旨在比较 FMT 治疗复发性艰难梭菌感染（CDI）后 rUTI 患者和无 rUTI 既往诊断患者的尿路感染（UTI）发生率。
这是一项回顾性队列研究，纳入了 2015 年至 2020 年期间在三级转诊中心数据库中接受 FMT 的女性患者。从电子病历中查询 FMT 前 3 年和后 5 年的人口统计学和 UTI 特征，并比较 rUTI 组和非 rUTI 组之间的差异。
共纳入 135 名患者，其中 17 名患者有 rUTI 既往史。rUTI 组在 FMT 前 1 年和 3 年时，经培养证实的 UTI 中位数分别为 1 次（P = 0.003）和 0 次（P < 0.001），而非 rUTI 组分别为 0 次。FMT 前后大多数 UTI 均为大肠埃希菌感染（53.8%），并携带一定的抗生素耐药性（54.6%）。相比之下，在 FMT 后 1 年，两组之间 UTI 发生频率或抗生素使用无差异（0 [0-1] vs 0.5 [0-1]，P = 0.28）。rUTI 组 FMT 后 1 年 UTI 发生频率呈下降趋势。生存分析显示，rUTI 组与非 rUTI 组相比，3 年 UTI 无复发率有下降趋势（76.5% vs 90.1%，P = 0.07）。
rUTI 患者接受 FMT 治疗复发性 CDI 后，UTI 发生频率呈下降趋势。
