Bladder bacterial diversity differs in continent and incontinent women: a cross-sectional study.
Bladder bacterial diversity differs in continent and incontinent women: a cross-sectional study.
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大陆和失败者的膀胱细菌多样性不同：一项横断面研究。
DOI：
10.1016/j.ajog.2020.04.033
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发表时间：
2020-11
影响因子：
9.8
通讯作者：
Brubaker L
中科院分区：
文献类型：
--
作者：
Price TK;Lin H;Gao X;Thomas-White KJ;Hilt EE;Mueller ER;Wolfe AJ;Dong Q;Brubaker L
自从发现膀胱微生物组（尿生物组）以来，人们越来越感兴趣的是了解尿生物组特征是否在临床表型中起作用和/或为患有常见形式的尿失禁（UI）的女性提供新的治疗方法。通过评估尿失禁状态与培养的尿生物群系之间的关联来验证我们的假设，即膀胱尿生物群系在大陆女性和受尿失禁影响的女性之间存在差异。在IRB监督下，从309名成年女性中采集经尿道插管尿液样本，根据经验证的盆底不适量表（PFDI）将其分为三组：大陆对照组（N = 150）和2个尿失禁（UI队列）-应激性尿失禁（SUI）（N = 50）和紧迫性尿失禁（UUI）（N = 109）。症状的严重程度进行了评估与排尿困难量表（UDI）的PFDI子量表评分。通过扩展定量尿液培养方案评估微生物，该方案检测最常见的膀胱微生物（细菌和酵母菌）。通过MALDI-TOF质谱法鉴定微生物的种属水平。计算培养阳性样本的α多样性指数，并在三组之间进行比较。估计了UDI评分与α多样性指数和物种丰度之间的关联。参与者的平均年龄为53岁（范围22 - 90）;大多数是白人（65%）。UI女性年龄稍大（对照组= 47，SUI = 54，UUI = 61）。根据设计，UDI症状评分不同（对照组= 8.43（10.1），SUI = 97.95（55.36），UUI = 93.71（49.12），p <0.001）。虽然大多数参与者（216，70%）具有扩增定量尿培养检测到的细菌，但UI队列的检测频率高于对照队列（对照= 57%，SUI 86%，UUI 81%，p <0.001）。最常检出的菌种如下：对照、惰性乳杆菌（12.7%）、咽峡炎链球菌（12.7%）、乳杆菌（12.7%）。卷边乳杆菌（10.7%）; gasseri（10%）; SUI，S. anginosus（26%）、L.葡萄球菌（18%）、表皮葡萄球菌（18%）和L. jensenii（16%）;心绞痛（30.3%）、L.加氏球菌（22%）、尿气球菌（18.3%）和迷走加德纳菌（17.4%）。然而，只有Actinotignum（原Actinobaculum）schaalii，A. urinae、A.与对照组相比，在至少一个UI组中，发现嗜血棒状杆菌、嗜脂棒状杆菌组的平均丰度显著更高（Wilcoxon p <0.02），并且在两个UI组之间没有个体属的显著差异。两个UI队列增加了α多样性相对于大陆控制的物种丰富度指数，但不均匀度，强烈相关的UI。在成年女性中，可培养的膀胱尿生物群系的组成与UI相关，无论常见的失禁亚型如何。检测到更多独特的活微生物与更严重的尿失禁严重程度相关。可培养的物种丰富度是显着更大的UI队列比大陆控制。成年女性膀胱尿生物群系的组成与尿失禁相关，并且更独特的微生物与更严重的尿失禁症状相关。
Since the discovery of the bladder microbiome (urobiome), interest has grown in learning whether urobiome characteristics have a role in clinical phenotyping and/or provide opportunities for novel therapeutic approaches for women with common forms of urinary incontinence (UI). To test our hypothesis that the bladder urobiome differs between continent women and women affected by UI by assessing associations between UI status and the cultured urobiome. With IRB oversight, transurethral catheterized urine specimens were collected from 309 adult women, who were categorized into three groups using response to the validated Pelvic Floor Distress Inventory (PFDI): Continent Controls (N=150) and 2 Urinary Incontinence (UI cohorts) - Stress Urinary Incontinence (SUI) (N=50) and Urgency Urinary Incontinence (UUI) (N=109). Symptom severity was assessed with the Urinary Distress Inventory (UDI) subscale score of the PFDI. Microbes were assessed by the Expanded Quantitative Urine Culture protocol, which detects the most common bladder microbes (bacteria and yeast). Microbes were identified to the species level by MALDI-TOF mass spectrometry. Alpha diversity indices were calculated for culture-positive samples and compared across the three groups. The association between UDI scores versus alpha diversity indices and species abundance were estimated. Participants had a mean age of 53 years (range 22-90); most were Caucasian (65%). Women with UI were slightly older (Control=47, SUI=54, UUI=61). By design, UDI symptom scores differed (Control = 8.43 (10.1), SUI = 97.95 (55.36), UUI = 93.71 (49.12), p<0.001). While most participants (216, 70%) had Expanded Quantitative Urine Culture-detected bacteria, the UI cohorts had a higher detection frequency than did the Control cohort (Control=57%, SUI 86%, UUI 81%, p<0.001). The most frequently detected species were as follows: Controls, Lactobacillus iners (12.7%), Streptococcus anginosus (12.7%), L. crispatus (10.7%), and L. gasseri (10%); SUI, S. anginosus (26%), L. iners (18%), Staphylococcus epidermidis (18%), and L. jensenii (16%); UUI, S. anginosus (30.3%), L. gasseri (22%), Aerococcus urinae (18.3%), and Gardnerella vaginalis (17.4%). However, only Actinotignum (formerly Actinobaculum) schaalii, A. urinae, A. sanguinicola, and Corynebacterium lipophile group were found at significantly higher mean abundances in at least one of the UI cohorts when compared to the Control cohort (Wilcoxon p<0.02), and no individual genus differed significantly between the two UI cohorts. Both UI cohorts had increased alpha diversity relative to continent controls with indices of species richness, but not evenness, strongly associated with UI. In adult women, the composition of the culturable bladder urobiome is associated with UI, regardless of common incontinence subtype. Detection of more unique living microbes was associated with worse incontinence severity. Culturable species richness is significantly greater in the UI cohorts than continent controls. The composition of the adult female bladder urobiome is associated with urinary incontinence and more unique microbes are associated with worse urinary incontinence symptoms.
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影响因子：
120.7
作者：
Sung, Vivian W.;Borello-France, Diane;Bann, Carla
通讯作者：
Bann, Carla
影响因子：
7.4
作者：
Fouts DE;Pieper R;Szpakowski S;Pohl H;Knoblach S;Suh MJ;Huang ST;Ljungberg I;Sprague BM;Lucas SK;Torralba M;Nelson KE;Groah SL
通讯作者：
Groah SL
影响因子：
1.8
作者：
Komesu YM;Richter HE;Carper B;Dinwiddie DL;Lukacz ES;Siddiqui NY;Sung VW;Zyczynski HM;Ridgeway B;Rogers RG;Arya LA;Mazloomdoost D;Gantz MG;Pelvic Floor Disorders Network
通讯作者：
Pelvic Floor Disorders Network
影响因子：
1.8
作者：
Thomas-White KJ;Gao X;Lin H;Fok CS;Ghanayem K;Mueller ER;Dong Q;Brubaker L;Wolfe AJ
通讯作者：
Wolfe AJ
影响因子：
6.4
作者：
Pearce MM;Hilt EE;Rosenfeld AB;Zilliox MJ;Thomas-White K;Fok C;Kliethermes S;Schreckenberger PC;Brubaker L;Gai X;Wolfe AJ
通讯作者：
Wolfe AJ