115 / 492
11:02 - 11:05
S7-3
(PP)
★
PREDICTION OF UTI FROM URINE MICROBIOME IN CHILDREN
Delshad MAGHDID
1
, Dirk KOK
2
, Jeroen SCHEEPE
1
, Katja WOLFFENBUTTEL
1
, Fred VAN DER TOORN
1
, Joop VAN DEN
HOEK
1
and Valentijn DREXHAGE
3
1) Erasmus MC, Urology, Rotterdam, NETHERLANDS - 2) Erasmus MC, Pediatric Urology, Rotterdam, NETHERLANDS - 3)
Dr. Schweitzer Hospital, Pediatrics, Dordrecht, NETHERLANDS
PURPOSE
Individual urinary tract infection (UTI) risk estimation in children is currently not available. There is growing evidence
that populations of bacteria, including pathogens, can survive long time in the urinary tract as a so-called microbiome.
That microbiome may play a key role in recurrent UTI’s. This encouraged us to develop a UTI prediction model based on
urine microbiome composition.
MATERIAL AND METHODS
Urine microbiome composition was studied by 16S rDNA analysis in 96 children under surveillance for UTI risk.
Microbiome composition was related to urine culture results obtained before and at sample collection and during 5 years
follow-up.
RESULTS
For the 96 samples, urine culture outcome was positive in 13, mixed in 16 and negative in 67. All samples however
contained a microbiome. Ninety-two percent of these microbiomes included potential uro-pathogens that constituted
around 43% of the total microbiome. Percentages of specific pathogens were highest in those patients who earlier had a
urine culture positive for that species (p<0.001). This suggests pathogen survival after treatment of UTI. In 93% of the
patients who developed E coli UTI during follow-up E coli was present in the microbiome. The individual risk for E coli
recurrence was accurately predicted from the percentage E coli within the microbiome.
CONCLUSIONS
All urine samples harbor a microbiome, often containing pathogens that may have survived after treatment of a prior
UTI or indicate bacterial growth enhancing host conditions. These pathogens might be the source of recurrent UTI. This
finding has important clinical consequences. As was shown here for E coli, the individual risk for UTI recurrence can be
predicted from the relative presence of E coli within the microbiome. This allows selection of high-risk patients who will
benefit most from prophylactic interventions and from maintaining normal voiding function.