scholarly journals The pelvis urinary microbiome in patients with kidney stones and clinical associations

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fengping Liu ◽  
Nan Zhang ◽  
Yunhong Wu ◽  
Peng Jiang ◽  
Tingting Jiang ◽  
...  
Keyword(s):  
Kidney Stones ◽  
Fasting Blood Glucose ◽  
Patient Characteristics ◽  
Urine Samples ◽  
Microbiome Composition ◽  
Kidney Pelvis ◽  
Microbiome Research ◽  
Urinary Microbiome ◽  
Clinical Associations ◽  
Bladder Urine

Abstract Background The long-held notion that, without urinary tract or circulatory infection, bladder urine and blood are sterile biofluids has been disproven. There have been no previous reports on the kidney pelvis urinary microbiome after bladder disinfection in kidney stone patients. This study aimed to determine whether a kidney pelvis urinary microbiome is present after eliminating the influence of the bladder urinary microbiome, whether the microbiome composition is different in patients with stone kidney pelvis (SKP) and non-stone kidney pelvis (NSKP), and the correlation between SKP and patient clinical characteristics. Results Comparisons of bacterial diversity and community structure exhibited that urine in bladder was similar to SKP and NSKP. However, the comparisons showed that urine samples were different from blood. The most common operational taxonomic units were shared by all three types of urine samples. Corynebacterium was significantly higher in SKP compared to NSKP. Several bacteria were associated with patient characteristics, including Lactobacillus, which was positively correlated with fasting blood glucose, and Prevotella was negatively correlated with BMI. Lactobacillus was significantly higher in SKP compared to blood but not in NSKP compared to blood. Conclusions The composition of the kidney pelvis urinary microbiome after disinfection of the bladder and its similarity to the bladder microbiome indicate that bladder urine can be used to replace kidney pelvis urine in microbiome research. Additionally, the comparison of SKP and NSKP and clinical associations suggest that the occurrence of kidney stones is responsible for the SKP urinary microbiome.

scholarly journals Profiling the urinary microbiome in men with calcium-based kidney stones

2020 ◽  
Author(s):  
Jing Xie ◽  
Jian-sheng Huang ◽  
Xiang-jiang Huang ◽  
Jun-ming Peng ◽  
Zhou Yu ◽  
...  
Keyword(s):  
Renal Pelvis ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Rrna Gene ◽  
Healthy Controls ◽  
Urinary Microbiome ◽  
Male Patients ◽  
Urinary Microbiota ◽  
Functional Pathways ◽  
Bladder Urine

Abstract Background The dogma that urine is sterile in healthy individuals has been overturned by recent studies applying molecular-based methods. Mounting evidences indicate that dysbiosis of the urinary microbiota is associated with several urological diseases. In this study, we aimed to investigate the characteristics of the urinary microbiome of patients with calcium-based kidney stones and compare it with those of healthy individuals.Method We collected bladder urine samples from 22 adult male patients with calcium-based kidney stones and 21 age-matched healthy controls by transurethral catheterization. For kidney stone patients, paired renal pelvis urine was also collected via ureteral catheter using aseptic technique. The V3-V4 region of the bacterial 16S rRNA gene was sequenced, and the urinary microbiota was analyzed by kidney stone status and specimen-type.Results The diversity of the urinary microbiota in kidney stone patients was significantly lower than that of healthy controls based on the Shannon and Simpson index (P<0.001 for both indices). The urinary microbiota structure also significantly differed between kidney stone patients and healthy controls (ANOSIM, R = 0.11, P <0.001). Differential representation of inflammation associated bacteria (e.g., Acinetobacter ) and several enriched functional pathways were identified in the urine of kidney stones patients. Meanwhile, we found the species diversity, overall composition of microbiota and predicted functional pathways were similar between bladder urine and renal pelvis urine in kidney stone patients.Conclusion A marked dysbiosis of urinary microbiota in male patients with calcium-based kidney stones was observed, which may be helpful to interpret the association between bacteria and calcium-based kidney stones.

scholarly journals Profiling the urinary microbiome in men with calcium-based kidney stones

2020 ◽  
Author(s):  
Jing Xie ◽  
Jian-sheng Huang ◽  
Xiang-jiang Huang ◽  
Jun-ming Peng ◽  
Zhou Yu ◽  
...  
Keyword(s):  
Renal Pelvis ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Healthy Controls ◽  
Healthy Individuals ◽  
Urinary Microbiome ◽  
Male Patients ◽  
Urinary Microbiota ◽  
Functional Pathways ◽  
Bladder Urine

Abstract Background The dogma that urine is sterile in healthy individuals has been overturned by recent studies applying molecular-based methods. Mounting evidences indicate that dysbiosis of the urinary microbiota is associated with several urological diseases. In this study, we aimed to investigate the characteristics of the urinary microbiome of patients with calcium-based kidney stones and compare it with those of healthy individuals. Method We collected bladder urine samples from 22 adult male patients with calcium-based kidney stones and 21 age-matched healthy controls by transurethral catheterization. For kidney stone patients, paired renal pelvis urine was also collected via ureteral catheter using aseptic technique. The V3-V4 region of the bacterial 16S rRNA gene was sequenced, and the urinary microbiota was analyzed by kidney stone status and specimen-type. Results The diversity of the urinary microbiota in kidney stone patients was significantly lower than that of healthy controls based on the Shannon and Simpson index (P<0.001 for both indices). The urinary microbiota structure also significantly differed between kidney stone patients and healthy controls (ANOSIM, R = 0.11, P <0.001). Differential representation of inflammation associated bacteria (e.g., Acinetobacter ) and several enriched functional pathways were identified in the urine of kidney stones patients. Meanwhile, we found the species diversity, overall composition of microbiota and predicted functional pathways were similar between bladder urine and renal pelvis urine in kidney stone patients. Conclusion A marked dysbiosis of urinary microbiota in male patients with calcium-based kidney stones was observed, which may be helpful to interpret the association between bacteria and calcium-based kidney stones.

scholarly journals Urinary Microbiome Characteristics in Female Patients with Acute Uncomplicated Cystitis and Recurrent Cystitis

2021 ◽  
Vol 10 (5) ◽  
pp. 1097
Author(s):  
Jeong-Ju Yoo ◽  
Hee Shin ◽  
Ju Song ◽  
Minjung Kim ◽  
Jina Yun ◽  
...  
Keyword(s):  
Urine Culture ◽  
Culture Methods ◽  
Microbiome Composition ◽  
Additional Information ◽  
Transurethral Catheter ◽  
Urinary Microbiome ◽  
Acute Uncomplicated Cystitis ◽  
The Difference ◽  
Uncomplicated Cystitis ◽  
Recurrent Cystitis

Traditionally, the diagnostic mainstay of recurrent urinary tract infection has been urinary culture. However, the causative uropathogen of recurrent cystitis has not been well established. Urine DNA next-generation sequencing (NGS) can provide additional information on these infections. Herein, we compared urine NGS results and urine cultures in patients with acute uncomplicated cystitis (AUC) and recurrent cystitis (RC), and evaluated the difference in microbiome patterns in the NGS results. Patients who underwent urine culture and NGS due to AUC or RC were retrospectively reviewed. All urine samples were collected via a transurethral catheter and studied utilizing a type of NGS called 16S ribosomal RNA gene amplification and sequencing. The sensitivity of urine NGS was significantly higher than that of conventional urine culture (69.0% vs. 16.7%, p < 0.05). The detection rate of urine NGS was slightly lower in the RC group than in the AUC group (67.7% vs. 72.7%). Microbiome diversity was significantly higher in the RC group compared to the AUC group (p = 0.007), and the microbiome composition was significantly different between the AUC and RC groups. In the urine NGS results, Pseudomonas, Acinetobacter, and Enterobacteriaceae were found in the AUC group, and Sphingomonas, Staphylococcus, Streptococcus, and Rothia spp. were detected in the RC group. Urine NGS can significantly increase the diagnostic sensitivity compared to traditional urine culture methods, especially in RC patients. AUC and RC patients had significant differences in bacterial diversity and patterns. Therefore, recurrent cystitis might be approached from a different perspective.

scholarly journals Urinary Lysosomal Enzyme Activities and Albuminuria in Ghanaian Patients with Type 2 Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Henry Asare-Anane ◽  
Felix Twum ◽  
Emmanuel Kwaku Ofori ◽  
Erving L. Torgbor ◽  
Seth D. Amanquah ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lysosomal Enzyme ◽  
Enzyme Activities ◽  
Renal Involvement ◽  
Fasting Blood Glucose ◽  
Urine Samples ◽  
Albumin Concentration ◽  
Spot Urine ◽  
Alanine Aminopeptidase

Renal tubular lysosomal enzyme activities like alanine aminopeptidase (AAP) and N-acetyl-β-D-glucosaminidase (NAG) have been shown to increase in patients developing diabetic nephropathy and nephrosclerosis. This study aimed to determine the activities of N-acetyl-β-D-glucosaminidase and alanine aminopeptidase and albumin concentration in urine samples of patients with type 2 diabetes. One hundred and thirty (65 type 2 diabetic and 65 nondiabetic) subjects participated in this study. Blood samples were drawn for measurements of fasting blood glucose, albumin (Alb), lipids, and creatinine (Cr). Early morning spot urine samples were also collected for activities of alanine aminopeptidase (AAP), N-acetyl-β-D-glucosaminidase (NAG), and concentration of albumin (U-Alb) and creatinine (U-Cr). Both NAG/Cr and AAP/Cr were significantly increased in diabetic subjects compared to controls (p<0.001). There was positive correlation between NAG/Cr and Alb/Cr (r=0.49,p<0.001) and between NAG/Cr and serum creatinine (r=0.441,p<0.001). A negative correlation was found between NAG/Cr and eGFR (r=-0.432,p<0.05). 9.3% and 12% of diabetics with normoalbuminuria had elevated levels of AAP/Cr and NAG/Cr, respectively. We conclude that measuring the urinary enzymes activities (NAG/Cr and AAP/Cr) could be useful as a biomarker of early renal involvement in diabetic complications.

Abstract WP336: Patient Characteristics and in Hospital Complications Associated With High Cost Ischemic Stroke Admissions

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Khawja A Siddiqui ◽  
Xiu Liu ◽  
Karen E Lynch ◽  
Sadiqa B Mahmood ◽  
Hui Zheng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Fasting Blood Glucose ◽  
Patient Characteristics ◽  
Artery Occlusion ◽  
Stroke Severity ◽  
Administrative Claims ◽  
Comfort Care ◽  
Logistic Regression Models ◽  
Public Health Burden ◽  
Targeted Interventions

Introduction: Stroke poses a major public health burden. We sought to determine the clinical and demographic variables associated with high cost among hospitalized ischemic stroke (IS) patients. Methods: Using our local Get with the Guidelines Stroke database, we identified 1,578 IS patients admitted from 2010- 2013 and linked them to administrative claims data (EPSI, inc). Patients in the highest cost quartile (n=394) were compared to all others (n=1184) using descriptive statistics and multilevel logistic regression models. All financial data are relative costs, reported as medians [IQR] multiplied by a constant. Results: The median relative cost in the top quartile was 4 times higher than that for all other patients. In univariate analyses, the groups differed substantially (Table 1). In multivariable models, high cost patients were more likely to have discharge ICD 9 codes of 433.11 or 434.91 (IS patients with carotid or cerebral artery occlusion), higher serum creatinine, fasting blood glucose and NIHSSS. They were more likely to receive IV or IA reperfusion, remain NPO during their stay or develop hospital acquired pneumonia, and less likely to transition to comfort care. The C statistic for a model with NIH stroke scale only performed well (c= 0.77) even when compared to a model with all variables present on admission (c= 0.83) or the fully adjusted model (c= 0.86). Conclusion: Many patient level demographic and clinical characteristics available on admission predict high cost, even after adjustment for stroke severity. Cost management opportunities may exist for targeted interventions, perhaps through geographic co-location or specialized stroke units.

Diet and the gut microbiome: from hype to hypothesis

2020 ◽  
Vol 124 (6) ◽  
pp. 521-530 ◽  
Author(s):  
Hannelore Daniel
Keyword(s):  
Intervention Studies ◽  
Dietary Intervention ◽  
Bacterial Biomass ◽  
Human Colon ◽  
Microbial Populations ◽  
Immune Defence ◽  
Human Intestine ◽  
Microbiome Composition ◽  
Microbiome Research ◽  
Complex Ecosystem

AbstractMicrobiome research in the last two decades has delivered as a key finding that the human intestine hosts a unique and complex ecosystem with many variables affecting the composition of the microbiota and in turn its function in metabolism and immune defence. Hundreds of external (environmental) factors have meanwhile been identified as significantly associated with bacterial biomass and diversity and, amongst these, diet is considered as a key determinant of microbial populations. However, dietary intervention studies, including those with fermentable substrates that have bulk effects on bowel functions, have revealed only very minor effects on overall microbiome composition and usually show only a very few species changing in population size. What that means in the context of hundreds of different species coexisting in competition or mutualism in the human colon is far from understood. This review addresses some of the current limits in research on diet effects by taking anatomical and physiological features of the intestine into consideration. It also provides some recommendations on future human studies needed to assess how the diet influences the microbiome and associated effects on metabolic health.

scholarly journals Influence of Patient Characteristics on The Type of Insulin Therapy Obtained by Diabetes Type 2 Outpatient in Denpasar Municipality

2017 ◽  
Vol 1 (2) ◽  
pp. 139
Author(s):  
Luh Putu Febrayana Larasanty ◽  
I GNA. Dewantara Putra ◽  
Rhyce Dewata Sari ◽  
Komang Dede Saputra ◽  
I GA. Gede Minanjaya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Insulin Therapy ◽  
Glucose Level ◽  
Medical Records ◽  
Fasting Blood Glucose ◽  
Patient Characteristics ◽  
Postprandial Blood Glucose

This study aims to investigate the influence of patient characteristics on the choice of insulin therapy in type 2 diabetes mellitus outpatients in Denpasar municipality. This is a descriptive analysis study using the patient's medical records as research material. Patients who meet inclusion and exclusion criteria are being recorded based on their medical records. Characteristics that are taken are age, gender, fasting blood glucose level (FBG), 2-hour postprandial blood glucose level (2-hours PPG) and HbA1c values of patients. Types of insulin therapy gained from patient medical records and drug use report in pharmacy. Characteristics data and type of insulin analyzed using correlation test to determine the effect of the patient characteristics on the selection of insulin therapy. 43 patients became the research subject. Males gendered patients (72.09%) and the patients aged less than 65 years (90.70%) are the dominant characteristics of the research subjects. The average value of FBG of patients is 212 mg / dL; 2-hours PPG 280 mg / dL and HbA1c 10.1%. There is a correlation between sex, age, HbA1c value and FBG with the type of insulin obtained by patients (p <0.05). Based on the results of statistical tests, age and gender have a strong correlation on insulin choice, HbA1c and FBG level has a moderate influence and 2-hours PPG have a weak correlation. Patient characteristics had an influence on the type of insulin choice for diabetes mellitus type 2 outpatient in the Denpasar municipality.

scholarly journals Molecular Reconstruction of the Diet in Human Stool Samples

mSystems ◽  
2019 ◽  
Vol 4 (6) ◽  
Author(s):  
Frank Maixner
Keyword(s):  
Human Subjects ◽  
Human Microbiome ◽  
Microbial Composition ◽  
Microbiome Composition ◽  
Diet Surveys ◽  
Dna Metabarcoding ◽  
Microbiome Research ◽  
Dietary Records ◽  
Stool Samples ◽  
Chloroplast Dna Markers

ABSTRACT Understanding dietary effects on the gut microbial composition is one of the key questions in human microbiome research. It is highly important to have reliable dietary data on the stool samples to unambiguously link the microbiome composition to food intake. Often, however, self-reported diet surveys have low accuracy and can be misleading. Thereby, additional molecular biology-based methods could help to revise the diet composition. The article by Reese et al. [A. T. Reese, T. R. Kartzinel, B. L. Petrone, P. J. Turnbaugh, et al., mSystems 4(5):e00458-19, 2019, https://doi.org/10.1128/mSystems.00458-19] in a recent issue of mSystems describes a DNA metabarcoding strategy targeting chloroplast DNA markers in stool samples from 11 human subjects consuming both controlled and freely selected diets. The aim of this study was to evaluate the efficiency of this molecular method in detecting plant remains in the sample compared to the written dietary records. This study displays an important first step in implementing molecular dietary reconstructions in stool microbiome studies which will finally help to increase the accuracy of dietary metadata.

scholarly journals Quality and cost assessment of Canadian Urological Association microscopic hematuria guidelines in clinical practice: Turning urine into gold

2019 ◽  
Vol 13 (10) ◽  
Author(s):  
Mark A. Assmus ◽  
D. Beyer ◽  
Joan Hanks ◽  
Mathew Estey ◽  
Keith F. Rourke ◽  
...  
Keyword(s):  
Guideline Adherence ◽  
Healthcare Costs ◽  
Patient Characteristics ◽  
Urine Samples ◽  
Microscopic Hematuria ◽  
Low Grade ◽  
Normal Cytology ◽  
Non Invasive ◽  
Database Evaluation ◽  
Alberta Health

Introduction: Asymptomatic microscopic hematuria (AMH) is defined in the Canadian Urological Association (CUA) guidelines as >2 red blood cells (RBCs) per high-powered field (hpf). Our objective is to evaluate guideline adherence for AMH at our centre. Secondarily, we aim to identify areas of the guideline that can be optimized. Methods: We retrospectively reviewed 875 consecutive adults referred to two urologists for hematuria from June 2010–2016. Patient characteristics, risk factors, and outcomes were added to an encrypted REDCap database. Evaluation of microscopic hematuria reporting was performed by analyzing 681 urine samples reported as 1–5 RBC/hpf. Healthcare costs were obtained from Alberta Health Services (AHS), Data Integration and Management Repository (DIMR), and Alberta Society of Radiologists (ASR). Results: Of the 875 patients referred with hematuria, 400 had AMH. Overall, 96.5% completed evaluation consistent with the CUA guideline. The incidence of pathology requiring surgical intervention was 21/400 (5%), with a 0.8% rate (3/400) of urothelial cell carcinoma (UCC) (non-invasive, low-grade). No malignancy was found in non-smokers with normal cytology, normal imaging and <50 RBC/hpf; 44% had AMH in the 1–5 RBCs/hpf range. Only 41% (279/681) of urine samples categorized as 1–5 RBCs/hpf had guideline-defined microscopic hematuria. By changing local microscopic hematuria reporting to differentiate 1–2 and 3–5 RBCs/hpf, we estimate $745 000 in annual savings. Conclusions: At our centre, CUA AMH guideline adherence is high. We did not find malignancy in non-smokers with normal cytology, imaging, and <50 RBC/hpf. We identified and changed regional microscopic hematuria reporting to fit the CUA definition, eliminating unnecessary investigations and healthcare costs.

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