Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure

Kait F. Al; John D. Denstedt; Brendan A. Daisley; Jennifer Bjazevic; Blayne K. Welk; Stephen E. Pautler; Gregory B. Gloor; Gregor Reid; Hassan Razvi; Jeremy P. Burton

Cell Reports Medicine (Sep 2020)

Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure

Kait F. Al,
John D. Denstedt,
Brendan A. Daisley,
Jennifer Bjazevic,
Blayne K. Welk,
Stephen E. Pautler,
Gregory B. Gloor,
Gregor Reid,
Hassan Razvi,
Jeremy P. Burton

Affiliations

Kait F. Al: Centre for Human Microbiome and Probiotic Research, Lawson Health Research Institute, London, ON, Canada; Department of Microbiology and Immunology, The University of Western Ontario, London, ON, Canada
John D. Denstedt: Division of Urology, Department of Surgery, The University of Western Ontario, London, ON, Canada
Brendan A. Daisley: Centre for Human Microbiome and Probiotic Research, Lawson Health Research Institute, London, ON, Canada; Department of Microbiology and Immunology, The University of Western Ontario, London, ON, Canada
Jennifer Bjazevic: Division of Urology, Department of Surgery, The University of Western Ontario, London, ON, Canada
Blayne K. Welk: Division of Urology, Department of Surgery, The University of Western Ontario, London, ON, Canada
Stephen E. Pautler: Division of Urology, Department of Surgery, The University of Western Ontario, London, ON, Canada
Gregory B. Gloor: Department of Biochemistry, The University of Western Ontario, London, ON, Canada
Gregor Reid: Centre for Human Microbiome and Probiotic Research, Lawson Health Research Institute, London, ON, Canada; Department of Microbiology and Immunology, The University of Western Ontario, London, ON, Canada; Division of Urology, Department of Surgery, The University of Western Ontario, London, ON, Canada
Hassan Razvi: Division of Urology, Department of Surgery, The University of Western Ontario, London, ON, Canada
Jeremy P. Burton: Centre for Human Microbiome and Probiotic Research, Lawson Health Research Institute, London, ON, Canada; Department of Microbiology and Immunology, The University of Western Ontario, London, ON, Canada; Division of Urology, Department of Surgery, The University of Western Ontario, London, ON, Canada; Corresponding author

Journal volume & issue: Vol. 1, no. 6
p. 100094

Abstract

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Summary: Ureteral stents are commonly used to prevent urinary obstruction but can become colonized by bacteria and encrusted, leading to clinical complications. Despite recent discovery and characterization of the healthy urinary microbiota, stent-associated bacteria and their impact on encrustation are largely underexplored. We profile the microbiota of patients with typical short-term stents, as well as over 30 atypical cases (all with paired mid-stream urine) from 241 patients. Indwelling time, age, and various patient comorbidities correlate with alterations to the stent microbiota composition, whereas antibiotic exposure, urinary tract infection (UTI), and stent placement method do not. The stent microbiota most likely originates from adhesion of resident urinary microbes but subsequently diverges to a distinct, reproducible population, thereby negating the urine as a biomarker for stent encrustation or microbiota. Urological practice should reconsider standalone prophylactic antibiotics in favor of tailored therapies based on patient comorbidities in efforts to minimize bacterial burden, encrustation, and complications of ureteral stents.

Published in Cell Reports Medicine

ISSN: 2666-3791 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General)
Website: https://www.cell.com/cell-reports-medicine

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