ABSTRACT
In this paper, we present the results of research on the physicochemical properties of two selected faces of the struvite crystal, which is the main component of infectious urinary stones. Two main faces, (001) and ([Formula: see text]), ending the c-axis, were selected for the study. These faces are not related by symmetry relations, which means, among other things, that they should have a different atomic structure, which was confirmed experimentally. In addition, the studies show that the tested surfaces have hydrophilic properties, however, the ([Formula: see text]) face is more hydrophilic compared to the (001) face. The physicochemical properties of the crystal as a whole, as well as the physicochemical properties of these faces influence the magnitude of adhesion. The adhesive force in both water and artificial urine is greater for face ([Formula: see text]) compared to face (001). The assessment of the adhesion of Proteus mirabilis bacteria in artificial urine also shows that the adhesion is greater for face ([Formula: see text]) than for face (001). The adhesion of bacteria to the examined faces of the struvite crystal, and in particular the increased adhesion of bacteria to the face ([Formula: see text]), may be the first stage of biofilm formation, which may result in a high rate of recurrence of infectious urinary stones after treatment.
Subject(s)
Urinary Calculi , Urolithiasis , Humans , Struvite , Bacterial Adhesion , Urinary Calculi/chemistry , Urolithiasis/microbiologyABSTRACT
In recent years, there has been a continuous increase in the incidence of urolithiasis, especially in highly developed countries. Therefore, the question arises which factors specific to these countries may be responsible for the increase in the incidence of this disease. In this article, we try to assess the effect of phosphoric acid, a component of various carbonated drinks, including Coca-Cola, on the nucleation and growth of struvite crystals, which are the main component of infectious urinary stones. The research was carried out in the environment of artificial urine with and without the presence of Proteus mirabilis bacteria. In the latter case, the activity of bacterial urease was simulated by adding an aqueous ammonia solution. The obtained results indicate that phosphoric acid present in artificial urine causes the nucleation of struvite to shift towards a lower pH, which means that struvite nucleates earlier in artificial urine compared to the control test. The amount of struvite formed is the greater the higher the concentration of phosphoric acid. At the same time, as the concentration of phosphoric acid increases, the growing struvite crystals are larger, which is disadvantageous because they are more difficult to remove from the urinary tract along with the urine. For the highest levels of phosphoric acid tested, large dendrites are formed, which are particularly undesirable as they can damage the epithelium of the urinary tract. The effect of phosphoric acid on the nucleation and growth of struvite is explained in base of chemical speciation analysis. This analysis indicates that the MgHCit and MgCit- complexes have the main influence on the nucleation and growth of struvite in artificial urine in the presence of phosphoric acid. It should be keep in mind that all these effects of phosphoric acid are possible when the urinary tract is infected with urease-positive bacteria. In the absence of infection, phosphoric acid will not cause struvite to crystallize.
Subject(s)
Magnesium Compounds , Urolithiasis , Carbonated Beverages , Crystallization , Humans , Phosphates , Phosphoric Acids , Proteus mirabilis , Struvite/chemistry , Urease , Urine , Urolithiasis/chemically induced , Urolithiasis/microbiologyABSTRACT
BACKGROUND: This study compared the bacterial spectrum and antibiotic susceptibility of uropathogens in older and younger patients with urinary stones to provide appropriate antibiotic management. METHODS: We retrospectively reviewed urinary tract infection patients with urolithiasis, presented to Xiangya Hospital from March 2014 to April 2021. Patients were divided into older and younger groups according to 60 years of age. The bacterial spectrum and drug sensitivity of uropathogens were compared. RESULTS: A total of 542 strains of uropathogens (177 in older and 365 in younger groups) were isolated from 507 patients. E. coli (41.8% vs 43.6%) remains the most common pathogen, followed by E. faecalis (6.2% vs 9.6%) in older and younger groups, respectively. Particularly, K. pneumoniae was significantly more frequent in older (9.6%) than in younger group (4.7%, P < .05). E. faecium was substantially more prevalent in older group (6.2%) than in younger group (2.7%, P < .05). The proportion of males increased in older patients (47.3%) than in younger patients (34.9%, P = 0.007). In both groups, major Gram-negative bacteria (E. coli and K. pneumoniae) revealed a high sensitivity over 70% to piperacillin/tazobactam, imipenem and amikacin, whereas the resistance level was high to penicillin, tetracycline and vancomycin. Major Gram-positive (E. faecalis and E. faecium) isolates demonstrated high sensitivity of over 50% to gentamicin and vancomycin in both groups. Furthermore, uropathogens isolated from younger urolithiasis patients were more susceptible to antimicrobials than those isolated from older patients. CONCLUSIONS: The male increased in the older urolithiasis patients with UTI and uropathogens microbial spectrum in older urolithiasis patients are different from younger. High susceptibility and age should be utilized in empirical antibiotic selection to avoid increased multidrug-resistant bacteria.
Subject(s)
Anti-Infective Agents , Urinary Calculi , Urinary Tract Infections , Urolithiasis , Aged , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria , Drug Resistance, Bacterial , Escherichia coli , Female , Humans , Male , Microbial Sensitivity Tests , Retrospective Studies , Urinary Calculi/drug therapy , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Urolithiasis/drug therapy , Urolithiasis/microbiology , VancomycinABSTRACT
PURPOSE: The characteristics and resistance patterns of urine bacteriology urolithiasis patients between male and female have not been extensively studied. This study aims to investigate the gender differences in microbial spectrum and antibiotic susceptibility of uropathogens isolated from urolithiasis patients and provide insights for appropriate antimicrobial therapies. MATERIALS AND METHODS: We retrospectively collected clinical microbiology data from urine culture in urolithiasis patients between March 2014 and December 2018 in Xiangya Hospital. Then the patients were divided into male and female groups. The microbial spectrum and frequency of susceptibility to antibiotics were compared. RESULTS: A total of 359 uropathogen isolates were collected from 335 patients, including 144 males (43.0%) and 191 females (57.0%). E. coli dominated in both groups, indicating higher frequency in females (53.2%) than in males (26.6%, p < 0.001), followed by E. faecalis, with higher frequency in males (15.6%) than in females (2.9%, p < 0.001). Major Gram-negative (E. coli and K. pneumoniae) bacteria showed high sensitivity to cefoperazone/sulbactam, cefotetan, piperacillin/ tazobactam, and amikacin. In contrast, the resistance level was high to penicillin, tetracycline, and vancomycin in both groups. Gram-positive (E. faecalis and E. faecium) isolates demonstrated high sensitivity to gentamicin and vancomycin in both groups. Furthermore, uropathogens isolated from female urolithiasis patients were more susceptible to antimicrobials than males. CONCLUSIONS: Uropathogen microbial spectrum in female urolithiasis patients is different from males. High susceptibility antibiotics should be used empirically according to gender to avoid multidrug-resistant bacteria increase.
Subject(s)
Drug Resistance, Bacterial , Urinary Tract Infections , Urolithiasis , Adult , Aged , Anti-Bacterial Agents/pharmacology , Bacteria/drug effects , Bacteria/isolation & purification , Female , Humans , Male , Middle Aged , Retrospective Studies , Sex Factors , Urinary Tract Infections/epidemiology , Urinary Tract Infections/microbiology , Urolithiasis/epidemiology , Urolithiasis/microbiologyABSTRACT
To determine whether functionally relevant questions associated with the urinary or gut microbiome and urinary stone disease (USD) can be answered from metagenome-wide association studies (MWAS), we performed the most comprehensive meta-analysis of published clinical MWAS in USD to date, using publicly available data published prior to April 2021. Six relevant studies met inclusion criteria. For alpha-diversity, significant differences were noted between USD status, stone composition, sample type, study location, age, diet, and sex. For beta-diversity, significant differences were noted by USD status, stone composition, sample type, study location, antibiotic use (30 days and 12 months before sampling), sex, hypertension, water intake, body habitus, and age. Prevotella and Lactobacillus in the gut and urinary tract, respectively, were associated with healthy individuals, while Enterobacteriaceae was associated with USD in the urine and stones. Paradoxically, other Prevotella strains were also strongly associated with USD in the gut microbiome. When data were analyzed together, USD status, stone composition, age group, and study location were the predominant factors associated with microbiome composition. Meta-analysis showed significant microbiome differences based on USD status, stone composition, age group or study location. However, analyses were limited by a lack of public data from published studies, metadata collected, and differing study protocols. Results highlight the need for field-specific standardization of experimental protocols in terms of sample collection procedures and the anatomical niches to assess, as well as in defining clinically relevant metadata and subphenotypes such as stone composition. IMPORTANCE Studies focused on the microbiome broadly support the hypothesis that the microbiome influences the onset of chronic diseases such as urinary stone disease. However, it is unclear what environmental factors shape the microbiome in ways that increase the risk for chronic disease. In addition, it is unclear how differences in study methodology can impact the results of clinical metagenome-wide association studies. In the current meta-analysis, we show that age, stone composition, and study location are the predominant factors that associate with the microbiome and USD status. Furthermore, we reveal differences in results based on specific analytical protocols, which impacts the interpretation of any microbiome study.
Subject(s)
Metagenome , Microbiota/genetics , Urinary Calculi/chemistry , Urolithiasis/microbiology , Humans , Male , Microbiota/physiology , Urinary Tract/microbiology , Urinary Tract/pathologyABSTRACT
Kidney stone disease is one of the oldest diseases known to medicine; however, the mechanisms of stone formation and development remain largely unclear. Over the past decades, a variety of theories and strategies have been developed and utilized in the surgical management of kidney stones, as a result of recent technological advances. Observations from the authors and other research groups suggest that there are five entirely different main mechanisms for kidney stone formation. Urinary supersaturation and crystallization are the driving force for intrarenal crystal precipitation. Randall's plaques are recognized as the origin of calcium oxalate stone formation. Sex hormones may be key players in the development of nephrolithiasis and may thus be potential targets for new drugs to suppress kidney stone formation. The microbiome, including ureaseproducing bacteria, nanobacteria and intestinal microbiota, is likely to have a profound effect on urological health, both positive and negative, owing to its metabolic output and other contributions. Lastly, the immune response, and particularly macrophage differentiation, play crucial roles in renal calcium oxalate crystal formation. In the present study, the current knowledge for each of these five aspects of kidney stone formation is reviewed. This knowledge may be used to explore novel research opportunities and improve the understanding of the initiation and development of kidney stones for urologists, nephrologists and primary care.
Subject(s)
Calcinosis/metabolism , Gastrointestinal Microbiome , Kidney Calculi/metabolism , Kidney/metabolism , Urolithiasis/metabolism , Apatites/metabolism , Calcinosis/microbiology , Calcium Oxalate/metabolism , Calcium Phosphates/metabolism , Humans , Kidney/microbiology , Kidney/pathology , Kidney Calculi/microbiology , Struvite/metabolism , Uric Acid/metabolism , Urolithiasis/microbiologyABSTRACT
Numerous metagenome-wide association studies (MWAS) for urolithiasis have been published, leading to the discovery of potential interactions between the microbiome and urolithiasis. However, questions remain about the reproducibility, applicability and physiological relevance of these data owing to discrepancies in experimental technique and a lack of standardization in the field. One barrier to interpreting MWAS is that experimental biases can be introduced at every step of the experimental pipeline, including sample collection, preservation, storage, processing, sequencing, data analysis and validation. Thus, the introduction of standardized protocols that maintain the flexibility to achieve study-specific objectives is urgently required. To address this need, the first international consortium for microbiome in urinary stone disease - MICROCOSM - was created and consensus panel members were asked to participate in a consensus meeting to develop standardized protocols for microbiome studies if they had published an MWAS on urolithiasis. Study-specific protocols were revised until a consensus was reached. This consensus group generated standardized protocols, which are publicly available via a secure online server, for each step in the typical clinical microbiome-urolithiasis study pipeline. This standardization creates the benchmark for future studies to facilitate consistent interpretation of results and, collectively, to lead to effective interventions to prevent the onset of urolithiasis, and will also be useful for investigators interested in microbiome research in other urological diseases.
Subject(s)
Microbiological Techniques/standards , Microbiota , Urolithiasis/microbiology , HumansABSTRACT
AIM: The objectives of this study were to evaluate the impact of preoperative urine culture and the infected nature of stones on the occurrence of postoperative urinary sepsis. MATERIAL AND METHODS: A prospective monocentric study included 29 patients operated on for urolithiasis between January and June 2018. RESULTS: Postoperative urinary sepsis was observed in 4 patients (14%). Urinary colonization rate on preoperative CBU exam was 27.6% (8 of 29) while the rate of colonized stones was 31% (9 of 29). The occurrence of urinary sepsis was observed in 37.5% (3 of 8) of patients with urinary colonization, compared to 44.4% of patients with colonized stones (4 of 9). By comparing the bacteriological results observed during sepsis, the germs isolated in postoperative urine were the same found in the culture of stones. The chemical nature of the colonized stones was mainly calcium oxalate (monohydrate, dihydrate) P=0.02. There was a statistically significant correlation between the preoperative urine culture, the bacteriological culture of stones and the postoperative urinary sepsis (P=0.05, P=0.005) respectively. CONCLUSION: Our study demonstrated a strong association between the bacteriological culture of stones and postoperative urinary sepsis superior to preoperative urine culture. It makes it possible to anticipate the occurrence of sepsis in patients requiring many endoscopic treatments. However, several multicentric prospective series may prove necessary to validate these results. LEVEL OF EVIDENCE: 3.
Subject(s)
Bacteria/isolation & purification , Postoperative Complications/epidemiology , Postoperative Complications/microbiology , Sepsis/epidemiology , Urinary Calculi/microbiology , Urinary Calculi/surgery , Urinary Tract Infections/epidemiology , Adult , Correlation of Data , Female , Humans , Male , Middle Aged , Morocco , Preoperative Period , Prospective Studies , Risk Assessment , Urinary Calculi/urine , Urine/microbiology , Urolithiasis/microbiology , Urolithiasis/surgery , Urolithiasis/urineABSTRACT
OBJECTIVE: To understand the relationship between urinary stones and the gut microbiome and to screen for microbial species that may be involved in stone formation. METHODS: Stool samples were collected from patients with urolithiasis and healthy patients between March and December 2017. The samples were analyzed by 16S sequencing to determine differences in the microbiome profiles between the two groups. The mouse model was established and was divided into two groups. Fecal samples were collected from the mice before gavage and three weeks postgavage for microbiome analysis. The microbial population of each group was analyzed to screen for microbial species that may affect the formation of urinary stones. Differences in the number of crystals in the renal tubules of the mice were examined by necropsy. RESULTS: The microbial composition was different between urolithiasis patients and healthy controls. The urolithiasis patients had significantly reduced microbial abundance; however, increased proportions of Bacteroidetes and Actinobacteria were detected compared to healthy controls. Furthermore, the abundance of Alistipesindistinctus and Odoribactersplanchnicus was significantly increased in the urolithiasis patients compared to the healthy controls. In addition, the incidence of urolithiasis was much higher in the experimental mouse group (stone solution + urolithiasis patient stool) than in the control mouse group. However, the microbial abundance before gavage was not significantly different from that seen three weeks postgavage. CONCLUSION: Theurolithiasis patients in this study had a different gut microbiome when compared with that of healthy individuals. The altered microbiome increased the rate of crystal formation in renal tubules and accelerated urinary stone formation in the mouse model of urolithiasis.
Subject(s)
Gastrointestinal Microbiome/genetics , Urinary Calculi/microbiology , Actinobacteria/genetics , Animals , Bacteroidetes/genetics , Feces/microbiology , Female , Humans , Kidney Tubules/microbiology , Male , Mice , Urolithiasis/microbiologyABSTRACT
Ð systemic assessment of the state of the human intestinal microbiome was carried out in relation to its function in the macroorganism, aimed at providing the nutriome, and the factors that determine the adequate nutritional status. A new concept of "reference gut microbiome of a healthy person" was postulated and the requirements to it were formulated: interaction with the host according to the principle of mutualism, provision of immune balance with the macroorganism due to the correct formation of mucosal immunity, implementation of metabolic and regulatory functions without losses for the nutriome. A set of characteristics and biomarkers reflecting the taxonomic composition and population properties of the microbial community, as well as the state of its essential immune and metabolic functions, was proposed as a criterion for its assessment in healthy adults who consume a diet balanced in nutritive and energy value, appropriate for age and energy spending. The influence of alimentary factors on the formation of the human intestinal microbiome in early ontogenesis, the nature of dysbiotic shifts, including those under common non-infectious alimentary-dependent diseases (obesity, food allergy, urolithiasis), in Russians were studied, the ways of their correction and maintenance of the intestinal microbiota in the process of life were substantiated taking into account modern knowledge.
Subject(s)
Diet , Gastrointestinal Microbiome/immunology , Dysbiosis/immunology , Dysbiosis/microbiology , Food Hypersensitivity/immunology , Food Hypersensitivity/microbiology , Humans , Obesity/immunology , Obesity/microbiology , Urolithiasis/immunology , Urolithiasis/microbiologyABSTRACT
Kidney stones affect nearly 10% of the population in North America and are associated with high morbidity and recurrence, yet novel prevention strategies are lacking. Recent evidence suggests that the human gut microbiota can influence the development of nephrolithiasis, although clinical trials have been limited and inconclusive in determining the potential for microbially based interventions. Here, we used an established Drosophila melanogaster model of urolithiasis as a high-throughput screening platform for evaluation of the therapeutic potential of oxalate-degrading bacteria in calcium oxalate (CaOx) nephrolithiasis. The results demonstrated that Bacillus subtilis 168 (BS168) is a promising candidate based on its preferential growth in high oxalate concentrations, its ability to stably colonize the D. melanogaster intestinal tract for as long as 5 days, and its prevention of oxalate-induced microbiota dysbiosis. Single-dose BS168 supplementation exerted beneficial effects on D. melanogaster for as long as 14 days, decreasing stone burden in dissected Malpighian tubules and fecal excreta while increasing survival and behavioral markers of health over those of nonsupplemented lithogenic controls. These findings were complemented by in vitro experiments using the established MDCK renal cell line, which demonstrated that BS168 pretreatment prevented increased CaOx crystal adhesion and aggregation. Taking our results together, this study supports the notion that BS168 can functionally reduce CaOx stone burden in vivo through its capacity for oxalate degradation. Given the favorable safety profile of many B. subtilis strains already used as digestive aids and in fermented foods, these findings suggest that BS168 could represent a novel therapeutic adjunct to reduce the incidence of recurrent CaOx nephrolithiasis in high-risk patients.IMPORTANCE Kidney stone disease is a morbid condition that is increasing in prevalence, with few nonsurgical treatment options. The majority of stones are composed of calcium oxalate. Unlike humans, some microbes can break down oxalate, suggesting that microbial therapeutics may provide a novel treatment for kidney stone patients. This study demonstrated that Bacillus subtilis 168 (BS168) decreased stone burden, improved health, and complemented the microbiota in a Drosophila melanogaster urolithiasis model, while not exacerbating calcium oxalate aggregation or adhesion to renal cells in vitro These results identify this bacterium as a candidate for ameliorating stone formation; given that other strains of B. subtilis are components of fermented foods and are used as probiotics for digestive health, strain 168 warrants testing in humans. With the severe burden that recurrent kidney stone disease imposes on patients and the health care system, this microbial therapeutic approach could provide an inexpensive therapeutic adjunct.
Subject(s)
Bacillus subtilis/metabolism , Calcium Oxalate/metabolism , Urolithiasis/microbiology , Animals , Disease Models, Animal , Dogs , Drosophila melanogaster/microbiology , Female , High-Throughput Screening Assays , Intestines/microbiology , Madin Darby Canine Kidney Cells , Male , Urolithiasis/drug therapyABSTRACT
The purpose of this study is to collect information on the bacterial resistance to antibiotics of bacteria isolated from urine cultures of patients treated for upper urinary tract calculi. Data of patients with urinary tract infection and urolithiasis were retrospectively reviewed to collect information on age, gender, stone size, location, hydronephrosis, procedure of stone removal and antibiotic treatment, identification and susceptibility of pathogens, symptoms, and infectious complications. A total of 912 patients from 11 centers in 7 countries (Bulgaria, Greece, Italy, North Macedonia, Spain, and Turkey) were studied. Mean age was 54 ± 16 years and M/F ratio 322/590. Out of 946 microbial isolates, the most common were E. coli, Gram-positive, KES group (Klebsiella, Enterobacter, Serratia), Proteus spp., and P. aeruginosa. Carbapenems, piperacillin/tazobactam and amikacin showed low resistance rates to E. coli (2.5%, 7%, and 3.6%) and Proteus spp. (7.7%, 16%, and 7.4%), but higher rates were observed with Klebsiella spp., P. aeruginosa, and Gram-positive. Fosfomycin had resistance rates less than 10% to E. coli, 23% to KES group, and 19% to Gram-positive. Amoxicillin/clavulanate, cephalosporins, quinolones, and TMP/SMX showed high resistance rates to most bacterial strains. High rates of antibiotic resistance were observed in patients candidate to stone treatment from South-Eastern Europe. The empirical use of antibiotics with low resistance rates should be reserved to the most serious cases to avoid the increase of multidrug resistant bacteria. Basing on our results, carbapenems, piperacillin/tazobactam, and amikacin may be a possible option for empiric treatment of urinary stone patients showing systemic symptoms.
Subject(s)
Anti-Infective Agents/pharmacology , Bacteria/drug effects , Bacterial Infections/microbiology , Urinary Tract Infections/microbiology , Urolithiasis/microbiology , Adult , Aged , Anti-Infective Agents/therapeutic use , Bacteria/isolation & purification , Bacterial Infections/drug therapy , Europe , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Retrospective Studies , Urinary Tract Infections/drug therapy , Urolithiasis/drug therapyABSTRACT
Mortality of mink kits represents a significant loss to production. However, causes of post-weaning mortality in mink kits in modern Danish mink production systems are still relatively poorly documented. We performed a cross-sectional mortality study on eight Danish mink farms including 1893 post mortem examinations of mink kits found dead or euthanized. We assessed the prevalence of cystitis and urolithiasis leading to mortality. Gross pathological findings as well as animal characteristics were recorded and associations with post mortem microbiology (using culture and MaldiTof-MS Vitek MS system) were investigated. Cystitis and/or urolithiasis were associated with death in 33 % (n = 476) and 37 % (n = 166) of the examined mink kits in 2015 and 2017. On farm level, the prevalence of cystitis and/or urolithiasis leading to mortality varied from 0.25 % to 1.27 % with a low overall mortality of 0.9-4.5 %. The bacterial agent most frequently isolated in post mortem bladder swabs from mink with a post mortem diagnosis of urolithiasis and cystitis was Staphylococcus delphini group A (51/283) with a significant (p < 0.0001, CI = [19.5;4745.7]) association to gross pathological findings in the urinary tract. Staphylococcus delphini group A was cultured from 70 % of the skin swabs obtained from apparently healthy mink euthanized at pelting (n = 222). In conclusion urinary tract disease (cystitis and urolithiasis) was the most prevalent post mortem diagnosis during the growth period and was associated with Staphylococcus delphini group A.
Subject(s)
Cystitis/veterinary , Mink/microbiology , Staphylococcal Infections/veterinary , Staphylococcus/pathogenicity , Urolithiasis/veterinary , Age Factors , Animals , Cross-Sectional Studies , Cystitis/microbiology , Cystitis/mortality , Denmark/epidemiology , Farms , Female , Male , Staphylococcal Infections/mortality , Staphylococcus/classification , Urolithiasis/microbiology , Urolithiasis/mortality , WeaningABSTRACT
Poorly crystalline and amorphous precipitate (PCaAP) is one of the components of the so-called infectious urinary stones, which are the result of the activity of urease-producing microorganisms, mainly from the Proteus species, in particular Proteus mirabilis. The main component of this kind of stones is crystalline struvite (MgNH4PO4â6H2O). Bacteria can build into the structure of the urinary stone and, in this way, they are one of the components of the urinary stone. From these three components - PCaAP, struvite and Proteus mirabilis - PCaAP exhibits the greatest ability to aggregate. The present study focuses on the aggregation of PCaAP. In particular, an influence of lipopolysaccharide (LPS) isolated from Proteus mirabilis on aggregation of PCaAP is presented. An aggregation of PCaAP is characterized by cross-sectional area of aggregates and zeta potential. The results demonstrate that, in artificial urine, the influence of freely suspended LPS on aggregation of PCaAP depends on the concentrations of LPS. Small concentrations of freely suspended LPS enhance the aggregation of PCaAP compared to the control test. For high concentrations of freely suspended LPS the formation of aggregates of PCaAP is inhibited. LPS, which is not freely suspended, but covers polystyrene latex beads, has no such properties. The investigations provide evidence for the importance of biological regulation in the PCaAP aggregation process.
Subject(s)
Proteus mirabilis/metabolism , Urinary Calculi/chemistry , Urinary Calculi/microbiology , Urinary Tract Infections/microbiology , Urolithiasis/pathology , Apatites/chemistry , Durapatite/chemistry , Humans , Lipopolysaccharides , Struvite/chemistry , Urine/microbiology , Urolithiasis/microbiologyABSTRACT
The prevalence of urinary stone disease (USD) is rapidly rising. However, the factors driving this increase are unknown. Recent microbiome studies suggest that dysbiosis may in part contribute to the increasing prevalence. The objective of the current study was to determine the nature and location of dysbiosis associated with USD. We conducted microbiome analysis from the gastrointestinal and urinary tracts, along with a metabolomic analysis of the urinary metabolome, from subjects with an active episode of USD or no history of the disease. Higher rates of antibiotic use among USD patients along with integrated microbiome and metabolomic results support the hypothesis that USD is associated with an antibiotic-driven shift in the microbiome from one that protects against USD to one that promotes the disease. Specifically, our study implicates urinary tract Lactobacillus and Enterobacteriaceae in protective and pathogenic roles for USD, respectively, which conventional, culture-based methods of bacterial analysis from urine and kidney stones would not necessarily detect. Results suggest that antibiotics produce a long-term shift in the microbiome that may increase the risk for USD, with the urinary tract microbiome holding more relevance for USD than the gut microbiome.
Subject(s)
Dysbiosis/microbiology , Gastrointestinal Microbiome , Urinary Tract/microbiology , Urolithiasis/microbiology , Adult , Cohort Studies , Female , Humans , Male , Metabolomics , Risk FactorsABSTRACT
Infectious urolithiasis is a consequence of long-standing urinary tract infections with urease-positive bacteria, especially Proteus spp. However, because of the often mixed nature of urinary tract infections, in the case of urinary stones formation, several species of bacteria may be involved in the process. The purpose of the study was to determine the impact of the bacterial species: Escherichia coli, Klebsiella pneumoniae, Providencia stuartii, Pseudomonas aeruginosa and Staphylococcus aureus on the crystallization caused by Proteus mirabilis. The studies were conducted in synthetic urine with the addition of P. mirabilis and a representative of another species. During the experiments the viability of bacteria, pH, presence and morphology of crystals, and the intensity of crystallization were assessed. Crystallization of calcium and magnesium phosphates occurred in all investigated configurations. However, there were differences observed in the course and intensity of crystallization between the mixed culture and the P. mirabilis culture. Although most intense crystallization took place in the pure culture of P. mirabilis it was also demonstrated that the presence of other uropathogens increased the survival of P. mirabilis. This synergistic effect could be responsible for the persistence and recurrence of urolithiasis in the urinary tract.
Subject(s)
Crystallization , Microbial Interactions , Proteus mirabilis/metabolism , Urine/chemistry , Urine/microbiology , Coinfection/microbiology , Escherichia coli/pathogenicity , Humans , Klebsiella pneumoniae/pathogenicity , Microbial Viability , Minerals , Urinary Tract Infections/microbiology , Urolithiasis/microbiologyABSTRACT
Female nude mice (J:NU-Foxn1nu; age, 6 wk) were injected with 1 million MCF7 human breast cancer cells in the fourth mammary fat pads and received a 21-d sustained-release estrogen pellet (0.25 mg) subcutaneously in the dorsum of the neck. All mice were maintained in sterile housing and provided sterile water and irradiated rodent chow. Approximately 6 wk after implantation, 4 of the 30 mice showed clinical signs of depression and dehydration. The 2 animals most severely affected were euthanized and presented for necropsy. The urinary bladders of these animals were distended with variable sized white, opaque uroliths. Urinalysis revealed coccal bacteria, erythrocytes, neutrophils and struvite crystals. Urine cultures from both necropsied animals grew heavy, pure growths of Staphylococcus xylosus. The organism was sensitive to all antibiotics tested except erythromycin (intermediate). Analysis of the uroliths revealed 100% struvite composition. Remaining mice in the study were evaluated clinically for hydration status, the ability to urinate, and the presence of palpable stones in the urinary bladder; one additional mouse had a firm, nonpainful bladder (urolithiasis suspected). Given the sensitivity of the organisms cultured from urine samples, the remaining mice were placed on enrofloxacin in the drinking water (0.5 mg/mL). All remaining mice completed the study without further morbidity or mortality. Previous studies have reported the association of estrogen supplementation with urinary bladder pathology, including infection and urolithiasis. Here we present a case of urolithiasis and cystitis in nude mice receiving estrogen supplementation that was associated with Staphylococcus xylosus, which previously was unreported in this context. When assessing these nude mice for urolithiasis, we found that visualizing the stones through the body wall, bladder palpation, and bladder expression were helpful in identifying affected mice.
Subject(s)
Cystitis/microbiology , Staphylococcus/isolation & purification , Urolithiasis/microbiology , Animals , Cystitis/pathology , Estrogens/pharmacology , Female , Humans , MCF-7 Cells , Mice , Mice, Nude , Struvite , Urolithiasis/pathologyABSTRACT
BACKGROUND: Struvite is one of the most common urinary/kidney stones, composed of magnesium ammonium phosphate (MgNHPO4·H2O). They are also termed as infection stones as these are associated with urinary tract infections. Numerous studies have been carried out to examine the growth and inhibition of struvite stones. OBJECTIVE: This review summarizes various reports on the factors responsible for inducing struvite stones in the kidney and gives a detailed account of studies on inhibition of growth of struvite crystals. RESULTS: The presence of urea-splitting bacteria such as Proteus mirabilis and alkaline pH plays a crucial role in struvite formation. In vitro inhibition of struvite stones by various chemical agents were examined mainly in artificial urine whereas inhibition by herbal extracts was studied in vitro by gel diffusion technique. Herbal extracts of curcumin, Boerhaavia diffusa Linn, Rotula aquatica and many other plants, as well as some chemicals like pyrophosphate, acetohydroxamic acid, disodium EDTA and trisodium citrate, were reported to successfully inhibit struvite formation. CONCLUSION: The present review recapitulates various factors affecting the growth of struvite urinary stones and the inhibitory role of certain chemicals and herbal extracts. Most of the tested plants are edible hence can be easily consumed without any adverse effects whereas the side effects of chemicals are unknown due to lack of toxicity studies. Thus, the use of herbal extracts might serve as an alternate and safe therapy for prevention of struvite stones.
Subject(s)
Plant Preparations/therapeutic use , Struvite/chemistry , Urinary Calculi/drug therapy , Urinary Tract Infections/drug therapy , Urolithiasis/drug therapy , Animals , Crystallization , Humans , Kidney/drug effects , Kidney/microbiology , Kidney/pathology , Plant Preparations/pharmacology , Struvite/adverse effects , Urinary Calculi/etiology , Urinary Calculi/microbiology , Urinary Tract Infections/etiology , Urinary Tract Infections/microbiology , Urolithiasis/etiology , Urolithiasis/microbiologyABSTRACT
AIM: To investigate the incidence of microorganisms of different taxonomic groups and their associations in the pelvic and bladder urine of adult urolithiasis patients. MATERIALS AND METHODS: A bacteriological method and metagenomic sequencing were used to investigate the bacterial spectrum of microflora cultured from pelvic and bladder urine sampled during surgical interventions in urolithiasis patients. RESULTS: The both microbiotas had approximately the same spectrum, but in 26.1% of patients it was inconsistent. Metagenomic analysis detected DNA of microorganisms in urine samples which were found free of microflora by the bacteriological method. CONCLUSION: The study findings showed species diversity of microorganisms cultured from pelvic and bladder urine sampled during surgical interventions in urolithiasis patients.
Subject(s)
Bacteria/isolation & purification , Urolithiasis/microbiology , Adult , Aged , Aged, 80 and over , Bacteria/genetics , Female , Humans , Male , Microbiota , Middle Aged , Urolithiasis/urine , Young AdultABSTRACT
No disponible