Decreased microbiota diversity associated with urinary tract infection in a trial of bacterial interference.
Decreased microbiota diversity associated with urinary tract infection in a trial of bacterial interference.
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DOI：
10.1016/j.jinf.2015.05.014
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Trautner BW
中科院分区：
文献类型：
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作者：
Horwitz D;McCue T;Mapes AC;Ajami NJ;Petrosino JF;Ramig RF;Trautner BW
长期留置导尿管的患者患导尿管相关性尿路感染(CAUTI)的风险很高。我们假设用一种良性的大肠杆菌菌株(E.coliHU2117，E.coli2117，一种E.coli2117的衍生物)定植膀胱将预防老年人导尿后的CAUTI。长期留置导尿管的成人接受了预涂有大肠杆菌HU2117的研究导尿管。我们对膀胱中的可培养微生物进行了28天的监测，直到大肠杆菌HU2117消失。纵向采集4例受试者的尿液，进行16S rRNA基因图谱分析。10名受试者中有8名(平均年龄70.9岁)感染了大肠杆菌HU2117，平均持续时间为57.7天(中位数：28.5，范围0-266)。所有受试者也仍然受到尿路病原体的侵袭。5名受试者发生侵袭性尿路感染，3例发热性尿路感染，2例尿毒症/菌血症，均与尿路病原体过度生长有关。大肠埃希菌HU2117的定植没有影响细菌膀胱的多样性，但发生感染的受试者膀胱微生物区系的多样性较低。用大肠杆菌HU2117定植并不能防止膀胱定植或随后的泌尿病原体侵袭性疾病。微生物多样性可能对导尿管膀胱侵袭性感染起到保护作用。
Patients with long-term indwelling catheters are at high risk of catheter-associated urinary tract infection (CAUTI). We hypothesized that colonizing the bladder with a benign E. coli strain (E. coli HU2117, a derivative of E. coli 83972 would prevent CAUTI in older, catheterized adults. Adults with chronic, indwelling urinary catheters received study catheters that had been pre-coated with E. coli HU2117. We monitored the cultivatable organisms in the bladder for 28 days or until loss of E. coli HU2117. Urine from 4 subjects was collected longitudinally for 16S rRNA gene profiling. Eight of the ten subjects (average age 70.9 years) became colonized with E. coli HU2117, with a mean duration of 57.7 days (median: 28.5, range 0-266). All subjects also remained colonized by uropathogens. Five subjects suffered invasive UTI, 3 febrile UTI and 2 urosepsis/bacteremia, all associated with overgrowth of a urinary pathogen. Colonization with E. coli HU2117 did not impact bacterial bladder diversity, but subjects who developed infections had less diverse bladder microbiota. Colonization with E. coli HU2117 did not prevent bladder colonization or subsequent invasive disease by uropathogens. Microbial diversity may play a protective role against invasive infection of the catheterized bladder.