Fecal Microbiota Transplantation for the Treatment of Refractory Recurrent Urinary Tract Infection

Jeney, Sarah E S; Lane, Felicia; Oliver, Andrew; Whiteson, Katrine; Dutta, Sonia

doi:10.1097/aog.0000000000004052

Cited by 15 publications

(27 citation statements)

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“…Five fecal samples were collected from each participant at times baseline, 1 week, and 1, 3, and 6 months post-FMT. Initial analysis of microbial community diversity was previously reported 8 Table 1. shows participant demographic and clinical information, including UTI, urine culture antibiotic resistance, and treatment during the trial.…”

Section: Resultsmentioning

confidence: 99%

“…Methods and primary outcome have previously been published. 8 Fecal microbiota transplantation entailed a slurry of 50 g fresh fecal material in 250 mL of sterile saline delivered for 30 minutes via retention enema. 11 Women with refractory rUTI despite 6 months of suppressive antibiotics were eligible.…”

Section: Methodsmentioning

confidence: 99%

“…For this analysis, we defined potential uropathogens to be bacteria (Escherichia coli, Enterococcus faecalis, Enterococcus faecium, Klebsiella pneumoniae, Pseudomonas aeruginosa) that caused UTI in the full case series. 8 Relative abundance is an ecological term used here to describe the percentage of a particular bacterial species among all bacteria identified in the sample. The relative uropathogen abundance for each participant was calculated through quantification of metagenomic sequence reads mapping to the species of interest at each time point (baseline, 1 week, and 1, 3, and 6 months after FMT) and presented as median and range by species.…”

Section: Methodsmentioning

confidence: 99%

“…A case series of FMT by retention enema showed a nonsignificant decrease in the number of UTIs and an increase in gut alpha diversity after FMT 8 . Fecal microbiota transplantation may be delivered via nasoenteric tube, oral tablet, colonoscopy, or retention enema.…”

mentioning

confidence: 99%

“…6,[8][9][10] A case series of FMT by retention enema showed a nonsignificant decrease in the number of UTIs and an increase in gut alpha diversity after FMT. 8 Fecal microbiota transplantation may be delivered via nasoenteric tube, oral tablet, colonoscopy, or retention enema. Retention enema was chosen in this study for its balance of risks and benefits because there was no indication for colonoscopy in these participants.…”

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confidence: 99%

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Fecal Putative Uropathogen Abundance and Antibiotic Resistance Gene Carriage in Women With Refractory Recurrent Urinary Tract Infection Treated With Fecal Microbiota Transplantation

Jeney

Avelar-Barragan²,

Whiteson³

et al. 2021

Female Pelvic Med Reconstr Surg

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ObjectiveThe aims of this study were to describe the fecal relative abundance of potentially uropathogenic bacteria and to analyze antibiotic resistance genes before and after fecal microbiota transplantation in women with recurrent urinary tract infection (UTI).MethodsShotgun sequencing was performed on fecal samples from 3 donors and 4 women with recurrent UTI who underwent transplantation. Recipient samples were sequenced at baseline and at 4 time points through 6 months postintervention. Relative fecal uropathogen abundance was analyzed by species and participant using descriptive statistics. Antibiotic resistance gene abundance was assigned, normalized, and compared between donors and recipients at baseline and postintervention using an abundance bar plot, nonmetric multidimensional scaling, and pairwise permutational multivariate analysis of variance.ResultsThe median (range) relative abundance of Escherichia coli in all fecal samples from women with recurrent UTI was 0% (0%–5.10%); Enterococcus faecalis, 0% (0%–0.20%); Enterococcus faecium, 0% (0%–1.90%); Klebsiella pneumoniae, 0% (0%–0.10%); and Pseudomonas aeruginosa, 0% (0%–0.10%). Gut microbes carried genes conferring resistance to antibiotics used for UTI. No significant difference was seen in antibiotic resistance gene carriage after transplantation compared with baseline (P=0.22, R2=0.08 at 3 months). Antibiotic gene composition and abundance were significantly associated with the individual from whom the sample came (P=0.004, R2=0.78 at 3 months).ConclusionsExploratory analysis of gut microbiomes in women with recurrent UTI identifies no or low relative putative uropathogen abundance for all species examined. Antibiotic resistance gene carriage persisted after fecal microbiota transplantation, although conclusions are limited by small sample size.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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