Urinary microbes and postoperative urinary tract infection risk in urogynecologic surgical patients.
Urinary microbes and postoperative urinary tract infection risk in urogynecologic surgical patients.
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DOI：
10.1007/s00192-018-3767-3
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发表时间：
2018-12
影响因子：
1.8
通讯作者：
Wolfe AJ
中科院分区：
文献类型：
--
作者：
Thomas-White KJ;Gao X;Lin H;Fok CS;Ghanayem K;Mueller ER;Dong Q;Brubaker L;Wolfe AJ
女性在泌尿妇科手术后发生尿路感染（UTI）的风险为20%。本研究评估了术前导尿样本中细菌与术后UTI的相关性。手术前即刻采集阴道拭子、会阴拭子和导尿管尿液样本，并对16 S rRNA基因的V4区进行测序。该队列以两种方式进行二分：1）标准手术日尿培养结果（阳性/阴性）和2）术后UTI的发生率（阳性/阴性）。评估膀胱、阴道和会阴微生物组的特征，以确定与术后UTI相关的因素。104例POP/UI手术患者中87%为白色;平均年龄为57岁。最常见的属是乳杆菌属，导尿管尿液中平均相对丰度为39.91%，阴道拭子中平均相对丰度为53.88%，会阴拭子中平均相对丰度为30.28%。两个不同的集群，基于导管尿液的分散（即，膀胱）微生物组在年龄、微生物和术后UTI风险方面具有高度显著性（p<2.2e-16）差异。术后UTI与膀胱微生物组最相关;邻近骨盆底壁龛中的微生物也有助于UTI风险。尿路感染风险与惰性乳杆菌的耗竭和多种尿路病原体混合物的富集有关。术后UTI风险似乎与术前膀胱微生物组组成相关，其中富含L。胰岛素似乎可以预防术后UTI。在接受泌尿妇科手术的成年女性中，术后UTI风险似乎与术前膀胱微生物组组成相关。
Women have a 20% risk of developing a urinary tract infection (UTI) following urogynecologic surgery. This study assessed the association of post-operative UTI with bacteria in pre-operative samples of catheterized urine. Immediately before surgery, vaginal swabs, perineal swabs and catheterized urine samples were collected and the V4 region of the 16S rRNA gene was sequenced. The cohort was dichotomized in two ways: 1) standard day-of-surgery urine culture result (positive/negative) and 2) occurrence of post-operative UTI (positive/negative). Characteristics of the bladder, vaginal and perineal microbiomes were assessed to identify factors associated with post-operative UTI. 87% of the 104 POP/UI surgical patients were white; the mean age was 57 years. The most common genus was Lactobacillus with a mean relative abundance of 39.91% in catheterized urine, 53.88% in vaginal swabs, and 30.28% in perineal swabs. Two distinct clusters, based on dispersion of catheterized urine (i.e., bladder) microbiomes, had highly significant (p<2.2e-16) differences in age, microbes and post-operative UTI risk. Post-operative UTI was most associated with the bladder microbiome; microbes in adjacent pelvic floor niches also contributed to UTI risk. UTI risk was associated with depletion of Lactobacillus iners and enrichment of a diverse mixture of uropathogens. Post-operative UTI risk appears associated with pre-operative bladder microbiome composition, where an abundance of L. iners appears to protect against post-operative UTI. In adult women undergoing urogynecologic surgery post-operative UTI risk appears associated with pre-operative bladder microbiome composition.
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影响因子：
3
作者：
Gao X;Lin H;Revanna K;Dong Q
通讯作者：
Dong Q
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：
4.4
作者：
Schloss, Patrick D.;Westcott, Sarah L.;Weber, Carolyn F.
通讯作者：
Weber, Carolyn F.
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
影响因子：
6.6
作者：
Fok, Cynthia S.;McKinley, Kathleen;Brubaker, Linda
通讯作者：
Brubaker, Linda