尿路菌群在女性急性单纯性和反复发作性下尿路感染特征

Characteristics of urinary tract microbiome in female patients with simple or recurrent urinary tract infection

摘要

目的 观察尿路菌群在急性单纯性和反复发作性下尿路感染的不同特征，以探索反复发作性尿路感染（recurrent urinary tract infection，rUTI）诊治新方向。 方法 纳入2020年5月至2021年9月重庆医科大学附属第一医院和奉节县人民医院的单纯下尿路感染女性患者53例，分为急性组27例和反复组26例，收集尿液标本进行尿培养并采用16s核糖体核糖核酸（16 sribosomal ribonucleic acid，16srRNA）二代测序检测尿液中菌群。 结果 ①2组尿路菌群在菌门中，俭菌超门急性组平均值0.004 9±0.0026，反复组平均值0.002 8±0.001 8，浮霉菌门急性组平均值0.003 5±0.001 9，反复组平均值0.002 3±0.002 0，差异有统计学意义（t=3.444、2.160，P=0.001、0.035）；在菌属中，急性组相对丰度平均值较高的菌属中，苍白杆菌属急性组平均值0.026 9±0.010 9，反复组平均值0.017 1±0.010 3，差异有统计学意义（t=3.372，P=0.001）；②急性组的α多样性分值中位数与反复组相比，差异无统计学意义；β多样性急性组矩阵距离中位数为0.277（0.225，0.361），反复组矩阵距离中位数为0.319（0.240，0.519），差异无统计学意义（F=2.259、R=0.042、P=0.027）；③组间相对丰度中位数具有明显差异的分类单元有α变形杆菌纲等。 结论 急性组和反复组的菌群多样性、菌群相对丰度、优势菌群差异明显。

Abstract

Objective To investigate the different characteristics of urinary tract microbiome in simple acute or recurrent lower urinary tract infection，and to explore the new directions for the diagnosis and treatment of recurrent urinary tract infection. Methods A total of 53 female patients with simple lower urinary tract infection who were treated in The First Affiliated Hospital of Chongqing Medical University and People’s Hospital of Fengjie from May 2020 to September 2021 were enrolled and divided into acute group with 27 patients and recurrent group with 26 patients. Urine samples were collected for culture，and 16s ribosomal ribonucleic acid next-generation sequencing was used to detect the microbiome in urine. Results At the phylum level，the mean value of OD1 was 0.004 9±0.002 6 in the acute group and 0.002 8±0.001 8 in the recurrent group，and the mean value of Planctomycetota was 0.003 5±0.001 9 in the acute group and 0.002 3±0.002 0 in the recurrent group，with significant differences between the two groups（t=3.444 and 2.160，P=0.001 and 0.035）；at the genus level，as for the genera with a relatively high mean value of relative abundance in the acute group，the mean value of Ochrobactrum was 0.026 9±0.010 9 in the acute group and 0.017 1±0.010 3 in the recurrent group，with a significant difference between the two groups（t=3.372，P=0.001）. There was no significant difference in the median of α diversity between the acute group and the recurrent group，and there was also no significant difference in the median of matrix distance for β diversity between the acute group and the recurrent group［0.277 （0.225，0.361） vs. 0.319（0.240，0.519），F=2.259，R=0.042，P=0.027］；α-Proteobacteria was one of the classification units with a significant difference in median relative abundance between the two groups. Conclusion There are significant differences in the diversity，relative abundance，and dominant flora of the microbiome between the acute group and the recurrent group.

关键词

尿路感染 / 尿路菌群 / 16s核糖体核糖核酸

Key words

urinary tract infection / urinary tract microbiome / 16s ribosomal ribonucleic acid

基金资助

重庆市科卫联合医学科研资助项目(2019ZDXM029)