Application of Various Techniques to Gain Insights Into the Complex Urinary Tract Microbial Communities of Renal Transplant Recipients

Abstract

which seeks novel cures for urinary disorders. S.S. participated in the design, performance of laboratory experiments, data analysis, and write-up. K.F. participated in the data analysis and write-up. D.R. participated in the data analysis and write-up. K.K.C. participated in the performance of laboratory experiments and data analysis. V.T. participated in the performance of laboratory experiments. F.M. participated in the design and Kidney TransplantationBackground. Urinary tract infections (UTIs) are prevalent in renal transplant (RT X ) recipients and associated with worse outcomes. Early detection by sensitive diagnostic tests and appropriate treatment strategies in this cohort is therefore crucial, but evidence has shown that current methods may miss genuine infections. Research has shed light on the urinary tract microbial ecology of healthy individuals and nontransplant patients with UTI, but information on the RTx cohort is scant. We conducted a cross-sectional study to (i) compare the gold standard diagnostic culture with alternative techniques and (ii) characterize RTx patient urinary microbial communities. Methods. Midstream urine specimens were collected from 51 RTx patients attending a renal transplant clinic and 27 asymptomatic controls. Urinary microscopy, dipstick, and routine culture were performed. To improve sensitivity of microbial detection, we cultured the urinary cell sediment and performed 16S rRNA gene sequencing on urine. Uroplakin-positive urothelial cells shed in urine were analyzed by immunofluorescence staining for any bacterial association. Results. Sediment culture and 16S rRNA sequencing confirmed detection deficiencies of diagnostic culture and revealed differences in the urobiomes of RTx patients and controls. Specifically, Gardnerella, Escherichia, and Lactobacillus were most abundant in patients, whereas Lactobacillus, Streptococcus, and Gardnerella were most abundant in controls. The application of both culture and sequencing provided a more nuanced view of the urinary microbial communities. Conclusions. This study provides insight into the potential problems of diagnostic culture within RTx patients and sheds light on their urinary microbial inhabitants. Further work may identify key microbial signatures and facilitate the development of better tools for UTI detection within this cohort, which could allow targeted intervention before an infection leads to serious consequences. http://links.lww.com/TXD/A479

Novel factors potentially initiating acute antibody‐mediated rejection in pig kidney xenografts despite an efficient immunosuppressive regimen

“…Although the evidence we provide is certainly not conclusive, and to our knowledge the detailed mechanism of AMR initiated by a renal infection has not been described in xenotransplantation previously, it is well-described in patients with ABO-incompatible kidney allografts. [33][34][35][36] We here provide a summary of one such (previously unpublished) clinical case.…”

Microbiome Dynamics: A Paradigm Shift in Combatting Infectious Diseases

“…This refers to the specific microbiome signatures associated with different diseases, allowing for targeted interventions and personalized treatment approaches. Researchers have identified distinct microbial communities linked to respiratory tract infections, UTIs, and skin infections [227,228]. Understanding these pathobiomes can guide therapeutic strategies by targeting specific microorganisms or manipulating the overall microbial composition to enhance treatment efficacy and improve patient outcomes.…”