First trimester "clean catch" urine and vaginal swab sample distinct microbiological niches.
First trimester "clean catch" urine and vaginal swab sample distinct microbiological niches.
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DOI：
10.1128/spectrum.02638-23
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发表时间：
2024-01-11
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
未经治疗的无症状细菌尿（ASB）与不良妊娠结局有关。因此，目前建议所有孕妇进行标准尿培养（SUC）常规筛查和ASB治疗。然而，通过扩展定量尿液培养方法（EQUC）和16S rRNA基因（扩增子）测序，SUC经常遗漏检测到的微生物。这些微生物（尿微生物组）的存在挑战了目前妊娠期ASB筛查的方法，因为它受到两个假设的限制：(i)女性膀胱自然无菌；（ii） SUC识别所有临床相关的泌尿病原体。为了确定泌尿和阴道微生物组的独特性或相似性，我们进行了一项经机构审查委员会（IRB）批准的前瞻性观察性队列研究，对单胎妊娠<14周的孕妇进行常规ASB筛查。同意的受试者提供配对的中游空尿和阴道拭子样本，通过EQUC和扩增子测序进行评估。这种相似性是由斯皮尔曼相关性决定的；采用随机抽样1000个，显著性阈值P < 0.001的bootstrap分析计算统计学显著性。我们使用贝叶斯定理来量化阴道微生物组可以作为患者尿液微生物组的代理，反之亦然。我们的研究结果提供了证据，表明EQUC和扩增子测序揭示了早期妊娠妇女尿液和阴道微生物组的相似观点。然而，虽然阴道和尿液微生物组成在同一个体中显著相关，但它们绝不是等同的。在怀孕的前三个月，泌尿和阴道微生物组是不同的，足以排除它们作为彼此的代理使用。未经治疗的无症状细菌尿（ASB）与不良妊娠结局相关，包括肾盂肾炎、早产和低出生体重儿。因此，目前建议所有孕妇进行标准尿培养（SUC）常规筛查和ASB治疗。为此，一些研究人员声称阴道拭子和尿液样本可以相互替代。由于SUC经常遗漏微生物，我们使用了两种更敏感的、最近验证的检测方法来比较妊娠早期女性尿液和阴道微生物组的组成。两种方法都得到了相似的结果。同一个体阴道和尿液微生物组成呈显著相关；然而，它们并不等同。我们认为，前三个月的尿液和阴道微生物组是截然不同的，足以排除它们作为相互代理的使用。
Untreated asymptomatic bacteriuria (ASB) has been associated with adverse pregnancy outcomes. Thus, routine screening by standard urine culture (SUC) and treatment of ASB are currently recommended for all pregnant women. However, SUC often misses microbes detected by expanded quantitative urine culture methods (EQUC) and 16S rRNA gene (amplicon) sequencing. The existence of these microbes (urinary microbiome) challenges the current approach to ASB screening in pregnancy as it is limited by two assumptions: (i) the female bladder is naturally sterile and (ii) SUC identifies all clinically relevant uropathogens. To determine the uniqueness or similarity between urinary and vaginal microbiomes, we performed a prospective observational institutional review board (IRB)-approved cohort study of pregnant women with a singleton pregnancy <14 weeks undergoing routine ASB screening. Consented subjects provided paired midstream voided urine and vaginal swab samples, which were assessed by EQUC and amplicon sequencing. The similarity was determined by Spearman’s correlation; statistical significance was calculated using bootstrap analysis with 1,000 random samples and a significance threshold of P value < 0.001. We used the Bayes theorem to quantify how well the vaginal microbiome could be used as a proxy for a patient’s urinary microbiome and vice versa. Our findings provide evidence that EQUC and amplicon sequencing reveal similar views of urinary and vaginal microbiomes in first trimester pregnant women. However, while vaginal and urinary microbial compositions were significantly correlated for the same individual, they were by no means equivalent. The first trimester urinary and vaginal microbiomes are distinct enough to preclude their use as proxies of each other. Untreated asymptomatic bacteriuria (ASB) has been associated with adverse pregnancy outcomes, including pyelonephritis, preterm labor, and low birth weight infants. Thus, routine screening by standard urine culture (SUC) and treatment of ASB are currently recommended for all pregnant women. For this purpose, some researchers claim that vaginal swabs and urine samples can be used as proxies for each other. Because SUC often misses microbes, we used two more sensitive, recently validated detection methods to compare the composition of the urinary and vaginal microbiomes of pregnant females in their first trimester. Both methods yielded similar results. Vaginal and urinary microbial compositions for the same individual were significantly correlated; however, they were not equivalent. We argue that first trimester urinary and vaginal microbiomes are distinct enough to preclude their use as proxies for each other.
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DOI：
10.4103/ijcm.ijcm_792_20
发表时间：
2021-07
期刊：
Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
影响因子：
--
作者：
Agarwal A;Pandey S;Maheshwari U;Singh MP;Srivastava J;Bose S
通讯作者：
Bose S
DOI：
10.1038/ismej.2012.8
发表时间：
2012-08
期刊：
The ISME journal
影响因子：
--
作者：
通讯作者：
--
影响因子：
0.9
作者：
Jacobs KM;Thomas-White KJ;Hilt EE;Wolfe AJ;Waters TP
通讯作者：
Waters TP
影响因子：
5.7
作者：
Lewis DA;Brown R;Williams J;White P;Jacobson SK;Marchesi JR;Drake MJ
通讯作者：
Drake MJ
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