The Interaction between Enterobacteriaceae and Calcium Oxalate Deposits

Abstract

BackgroundThe role of calcium oxalate crystals and deposits in UTI pathogenesis has not been established. The objectives of this study were to identify bacteria present in pediatric urolithiasis and, using in vitro and in vivo models, to determine the relevance of calcium oxalate deposits during experimental pyelonephritis.MethodsPediatric kidney stones and urine were collected and both cultured and sequenced for bacteria. Bacterial adhesion to calcium oxalate was compared. Murine kidney calcium oxalate deposits were induced by intraperitoneal glyoxalate injection and kidneys were transurethrally inoculated with uropathogenic Escherichia coli to induce pyelonephritisResults E. coli of the family Enterobacteriaceae was identified in patients by calcium oxalate stone culture. Additionally Enterobacteriaceae DNA was sequenced from multiple calcium oxalate kidney stones. E. coli selectively aggregated on and around calcium oxalate monohydrate crystals. Mice inoculated with glyoxalate and uropathogenic E. coli had higher bacterial burdens, increased kidney calcium oxalate deposits and an increased kidney innate immune response compared to mice with only calcium oxalate deposits or only pyelonephritis.ConclusionsIn a murine model, the presence of calcium oxalate deposits increases pyelonephritis risk, likely due to preferential aggregation of bacteria on and around calcium oxalate crystals. When both calcium oxalate deposits and uropathogenic bacteria were present, calcium oxalate deposit number increased along with renal gene transcription of inner stone core matrix proteins increased. Therefore renal calcium oxalate deposits may be a modifiable risk factor for infections of the kidney and urinary tract. Furthermore, bacteria may be present in calcium oxalate deposits and potentially contribute to calcium oxalate renal disease.

The Role of the Genitourinary Microbiome in Pediatric Urology: a Review

“…Other work has examined the vaginal microbiome in relation to age, in particular around menarche. Most have found that Lactobacillus species are less common before menarche, but there is a rapid transition to the “adult-type” microbiome dominated by Lactobacillus [16••, 17, 18]. However, Hickey et al recently found that the majority of vaginal microbiome samples showed a predominance of Lactobacilli in all ages, including premenarcheal girls, which is similar to previously reported microbiome makeup of both postmenarcheal girls and adult women.…”

“…While authors note that this discrepancy could be partially explained by the ability of the antibiotics to more effectively target bacteria in urine than those within the biofilm of the stones, authors postulate that calcium oxalate stones harbor a microbiome that is independent from that of the surrounding urine. Further, they postulate that the bacteria within the stone’s microbiome contribute to stone formation by altering urine supersaturation [16••]. Taken together, these data suggest that it may be possible that the stone microbiome could be predictive of stone recurrence; however, this possibility has yet to be studied.…”

The urinary microbiota: a paradigm shift for bladder disorders?

“…urinary stones. Investigators are beginning promising research to evaluate the FUM of these and other populations [1,4,37–41]. …”

Antibiotic- Associated Risk the Reduction of Lactobacillus Spp. In the Intestinal Microbiota in Patients With Urinary Tract Infections

“…

№2 (54) 2017Український журнал нефрології та діалізу Оригінальні наукові роботи ВСТУП. Як відомо, основою лікування інфекції сечової системи (ІСС) загалом та пієлонефриту, зокрема, є антибактеріальна терапія [1,4]. Проте, на сьогодні є доведеним, що застосування антибіотиків призводить до виражених короткострокових та довгострокових порушень біоценозу кишківника з неповним відновленням мікробіоти до вихідного складу на протязі декількох років [2,10].

…”

“…У попередніх дослідженнях нами було продемонстровано, що постійне застосування антибактеріальних лікарських засобів, у тому числі й довготривала антибіотикопрофілактика у хворих на рецидивуючий пієлонефрит, порушує видовий та кількісний склад мікробіоти кишківника з істотним знищенням Lactobacillus spp. та формуванням гіпероксалурії [1,78]. Разом з тим, вплив застосування антибіотиків, які найчастіше використовуються для лікування пацієнтів з ІСС, на кількісний склад Lactobacillus spp.…”