Decreased microbiota diversity associated with urinary tract infection in a trial of bacterial interference - 03/08/15
Summary |
Background |
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 Escherichia coli strain (E. coli HU2117, a derivative of E. coli 83972) would prevent CAUTI in older, catheterized adults.
Materials and methods |
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.
Results |
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.
Conclusions |
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.
Trial Registration:ClinicalTrials.gov, NCT00554996NCT00554996.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | We performed a clinical trial of bacterial interference to prevent urinary tract infection in older, catheterized adults. |
• | Bladder inoculation with Escherichia coli HU2117 (83972) did not prevent symptomatic infection of the urinary tract. |
• | 16S rRNA profiling revealed that subjects who developed symptomatic infections had less diverse bladder microbiota. |
• | Standard microbiological culture techniques identified only a fraction of the organisms present by sequencing. |
Keywords : Urinary tract infection, Probiotics, Microbiota, Biodiversity, Microbiome
Plan
Vol 71 - N° 3
P. 358-367 - septembre 2015 Retour au numéro
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