Gastrointestinal pathogen colonization and the microbiome in asymptomatic kidney transplant recipients

Westblade, Lars F.; Satlin, Michael J.; Albakry, Shady; Botticelli, Brittany; Robertson, A.; Alston, Tricia; Magruder, Matthew; Zhang, Lisa T.; Edusei, Emmanuel; Chan, Kee; Lubetzky, Michelle; Dadhania, Darshana; Pamer, Eric G.; Suthanthiran, Manikkam; Lee, John Y.K.

doi:10.1111/tid.13167

Cited by 15 publications

(10 citation statements)

References 17 publications

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“…There was a decrease in Firmicutes and an increase of Actinobacteria and Proteobacteria (Table 1). In a different study of 142 kidney transplant recipients, 27 pathogens such as C. difficile and E. coli were found in 30% of patients.…”

Section: Microbiota and Renal Transplantation Microbiota Composition Pre-/post-transplant Dysbiosis And Effect On The Immune Systemmentioning

confidence: 98%

The Microbiota and Kidney Transplantation: Influence on the Graft

Salvadori

Tsalouchos

2021

EMJ Urol

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The gut microbial community may be associated with complications after kidney transplantation. The indigenous microbiota has a significant and protective function that influences the transplant recipient response. Genetic or environmental factors may modify the indigenous microbiota and pathobionts appear. In this condition, several disturbances of the kidney graft may be observed. These include acute rejection, infection, diarrhoea, disturbance in the induction of tolerance, and modification of immunosuppressive drug metabolism. Recently, the use of prebiotics, probiotics, and synbiotics has been demonstrated to be effective in normalising these conditions and in restoring the generation of the normal indigenous microbiota. An improved understanding of the function and composition of the indigenous microbiota may help in finding further solutions to stabilise the microbiota after kidney transplantation.

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Section: Microbiota and Renal Transplantation Microbiota Composition Pre-/post-transplant Dysbiosis And Effect On The Immune Systemmentioning

confidence: 98%

The Microbiota and Kidney Transplantation: Influence on the Graft

Salvadori

Tsalouchos

2021

EMJ Urol

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“…17 Also, clinical relevance of multiple pathogens identified by molecular panel may be limited, as asymptomatic colonisation is common. 18 The three FDA-approved multiplex PCR…”

Section: Ta B L E 3 Diagnostic Yield Of Investigationsmentioning

confidence: 99%

“…17 Also, clinical relevance of multiple pathogens identified by molecular panel may be limited, as asymptomatic colonisation is common. 18 The three FDA-approved multiplex PCR Diarrhea in solid organ transplant recipients + -negative. 16 The utility of molecular panel in evaluation of diarrhea in solid organ transplant recipients needs to be studied prospectively in India, before widespread use in clinical practice can be recommended.…”

Section: Ta B L E 3 Diagnostic Yield Of Investigationsmentioning

confidence: 99%

Etiological profile of diarrhea in solid organ transplant recipients at a tertiary care center in Southern India

Vyas

Parameswaran

Paramasivan

et al. 2021

Transplant Infectious Dis

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Background: Diarrhea is one of the common gastrointestinal (GI) adverse events after solid organ transplantation. Diarrhea may be caused by infectious or non-infectious etiology. The infectious etiology of diarrhea varies according to the location and duration of diarrhea. Non-infectious etiologies include drugs, inflammatory bowel disease, neoplasia. The objective of this study was to evaluate the etiological profile of diarrhea in solid organ transplant recipients presenting to a tertiary care center in Southern India.Methods: This was a retrospective analysis of prospectively collected data of all solid organ transplantation recipients referred to the Department of Medical Gastroenterology for evaluation of diarrhea from April 2012 till May 2014. All patients had stool evaluated by wet mount examination, modified acid fast (AFB) stain, trichrome stain, culture, and Clostridium difficile toxin assay. EDTA plasma was collected for quantitative Cytomegalovirus (CMV) detection by real-time PCR. If the diarrhea was acute (<2 wk), and no etiological agent was identified, empirical antibiotic therapy was instituted and followed up. If persistent or chronic diarrhea (>2-4 wk), endoscopic evaluation (upper GI endoscopy and/or colonoscopy with biopsies), depending on the clinical type of diarrhea was done. If no specific etiological diagnosis was established after endoscopic evaluation, breath test for SIBO and celiac serology were done. If no specific etiology was identified after the above investigations, dose of immunosuppressive drugs was reduced. If diarrhea responded to dose reduction, it was considered to be drug related.Results: Fifty-eight episodes of diarrhea occurred in 55 solid organ transplant recipients during the study period. Renal transplant recipients constituted the majority (70%). Most (79%) of patients included in the study had their transplant > 6 mo ago.Infective diarrhea was the etiology in 46%, drug-related diarrhea in 29.3%. No specific etiology was identified in 22.4% of patients. Parasites accounted for 69% of all

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“…Prior studies suggest that colonization with C. difficile, specifically, toxigenic strains, is associated with decreased microbial diversity (17). Overall, 23/106 (22%) of the study participants were colonized with C. difficile (GDH assay) and the majority of these (14/23, 61%) were toxin B positive by PCR assay ( Table 1).…”

Section: Difficile Colonizationmentioning

confidence: 91%