Abstract: SA-PO500

Gut Microbiota Disturbances and Urinary Tract Infections in Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Lee, John Richard, Weill Cornell Medicine, New York, New York, United States
  • Magruder, Matthew, Weill Cornell Medicine, New York, New York, United States
  • Zhang, Lisa T, Weill Cornell Medicine, New York, New York, United States
  • Dadhania, Darshana, Weill Cornell Medicine, New York, New York, United States
  • Muthukumar, Thangamani, Weill Cornell Medicine, New York, New York, United States
  • Ling, Lilan, Memorial Sloan Kettering Cancer Center, New York, New York, United States
  • Pamer, Eric, Memorial Sloan Kettering Cancer Center, New York, New York, United States
  • Suthanthiran, Manikkam, Weill Cornell Medicine, New York, New York, United States
Background

Disturbances in the gut microbiota has been linked to infectious complications beyond C. difficile. In a pilot gut microbial profiling study, we found a link between the abundance of pathogenic gut microbiota and urinary tract infections (UTI) in kidney transplant recipients.

Methods

Herein, we perform a validation study using an independent cohort of 71 kidney transplant recipients. We collected 199 serial fecal specimens from this population in the first 3 months of transplantation and profiled their gut microbiota using 16S rRNA deep sequencing of the V4-V5 hypervariable region. Among the 71 subjects, 13 developed Proteobacteria UTIs and 58 subjects did not. We compared the gut microbial profiles in the 11 fecal specimens collected at the time of Proteobacteria UTI (Proteobacteria UTI Group) to the gut microbial profiles of 135 fecal specimens collected at the same time urine cultures were negative for Proteobacteria UTI (No Proteobacteria UTI Group).

Results

The fecal abundance of Proteobacteria, the phylum that contains gram negative pathogens like Escherichia, was significantly higher in the 11 fecal specimens from the Proteobacteria UTI Group than in the 135 fecal specimens from the No Proteobacteria UTI Group (1.3% vs. 0.2%, P=0.03, Wilcoxon rank sum) (Fig A). Predicted bacterial genes based on the 16S rRNA data (using PICRUSt) revealed lower metabolism related genes in the fecal specimens in the Proteobacteria UTI Group than in those in the No Proteobacteria UTI Group (Fig B).

Conclusion

Our identification of a gut microbiota-urinary tract infection relationship in kidney transplant recipients suggest that correction of gut dysbiosis may help prevent and/or treat UTIs, especially recurrent and multi-drug resistant UTIs.

Funding

  • Other NIH Support