Araujo Ricardo, Merino-Ribas Ana, Pereira Luciano, Campos Joana, Silva Nádia, Alencastre Inês Soares, Pestana Manuel, Sampaio-Maia Benedita
Nephrology & Infectious Diseases R&D Group, i3S - Instituto de Investigação e Inovação em Saúde, INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal.
Nephrology & Infectious Diseases R&D Group, i3S - Instituto de Investigação e Inovação em Saúde, INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal; Nephrology Department, Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
Nefrologia (Engl Ed). 2024 Mar-Apr;44(2):194-203. doi: 10.1016/j.nefroe.2024.04.004.
Diabetes, dyslipidemia, older age, gender, urinary tract infections, and recent antibiotic intake have been associated with a decrease in the urobiome richness and other fluctuations in this microbiome. Gut and blood microbiome have been reported to be altered in patients with chronic kidney disease (CKD), and specifically in peritoneal dialysis (PD) patients. Still, there are currently no studies describing the urogenital microbiome in CKD-PD patients. In this study we characterized the urobiome profile in 46 PD patients and analyzed its clinical and inflammatory parameters.
Mid-stream urine, fecal and blood samples were collected from 46 patients undergoing PD at Centro Hospitalar Universitário de São João (CHUSJ) in Porto, Portugal. Exclusion criteria were age under 18 years old, inability to give informed consent, history of infection in the last three months, and antibiotic intake in the last three months. The microbiome communities were analyzed by amplification and sequencing of the V3-V4 region of the bacterial 16S rRNA gene. Correlations with the patients' clinical data and inflammatory profile were performed.
CKD-PD patients presented a unique urobiome profile dominated by Bacillota, Actinomycetota and Pseudomonadota and characterized by a lower Shannon diversity than fecal and blood microbiome. The taxonomic profiles of urogenital samples were organized in multiple subtypes dominated by populations of Lactobacillus, Staphylococcus, Streptococcus, Gardnerella, Prevotella, Escherichia-Shigella, being similar to other non-PD-CKD patients. Gender, sCD14, residual diuresis and history of peritonitis were significantly associated to variations in the urobiome. Although not reaching statistical significance, diabetes and the time on PD also showed association with particular taxonomic groups. Depletion of Gardnerella, Staphylococcus, Corynebacterium, Lactobacillus or Dermabacter populations correlated with CKD-PD patients with history of diabetes, history of peritonitis and altered levels of sCD14.
Our results highlight urogenital microbiome as a potential partner and/or marker in the overall health state of CKD-PD patients.
糖尿病、血脂异常、老年、性别、尿路感染以及近期使用抗生素均与泌尿微生物群丰富度降低及该微生物群的其他波动有关。据报道，慢性肾脏病（CKD）患者，尤其是腹膜透析（PD）患者的肠道和血液微生物群会发生改变。然而，目前尚无关于CKD-PD患者泌尿生殖微生物群的研究。在本研究中，我们对46例PD患者的泌尿微生物群特征进行了分析，并分析了其临床和炎症参数。
从葡萄牙波尔图圣若昂大学医院中心（CHUSJ）接受PD治疗的46例患者中采集了中段尿、粪便和血液样本。排除标准为年龄在18岁以下、无法提供知情同意书、过去三个月内有感染史以及过去三个月内使用过抗生素。通过对细菌16S rRNA基因的V3-V4区域进行扩增和测序来分析微生物群落。并对患者的临床数据和炎症特征进行了相关性分析。
CKD-PD患者呈现出独特的泌尿微生物群特征，以厚壁菌门、放线菌门和假单胞菌门为主，其香农多样性低于粪便和血液微生物群。泌尿生殖样本的分类学特征分为多种亚型，以乳酸杆菌、葡萄球菌、链球菌、加德纳菌、普雷沃菌、大肠埃希菌-志贺菌种群为主，与其他非PD-CKD患者相似。性别、可溶性CD14（sCD14）、残余尿量和腹膜炎病史与泌尿微生物群的变化显著相关。虽然未达到统计学意义，但糖尿病和PD治疗时间也与特定分类菌群有关。加德纳菌、葡萄球菌、棒状杆菌、乳酸杆菌或皮肤杆菌种群的减少与有糖尿病史、腹膜炎病史和sCD14水平改变的CKD-PD患者相关。
我们的研究结果突出了泌尿生殖微生物群作为CKD-PD患者整体健康状况的潜在伙伴和/或标志物。
