Intestinal microbiology and urinary tract infection associated risk in long-term aged care residents
Date
2024
Authors
Miller, S.J.
Carpenter, L.
Taylor, S.L.
Wesselingh, S.L.
Choo, J.M.
Shoubridge, A.P.
Papanicolas, L.E.
Rogers, G.B.
Inacio, M.
Crotty, M.
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Journal article
Citation
Communications Medicine, 2024; 4(1):164-1-164-10
Statement of Responsibility
Sophie J. Miller, Lucy Carpenter, Steven L. Taylor, Steve L. Wesselingh, Jocelyn M. Choo, Andrew P. Shoubridge, Lito E. Papanicolas, Geraint B. Rogers, GRACE Investigator Group
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Abstract
Background: Urinary tract infections (UTI) are the most frequently diagnosed infection in residents of long-term care and are a major risk factor for urosepsis, hospitalisation, and death. Translocation of gut pathobionts into the urinary tract is the presumed cause of most UTIs. While specific gut microbiota characteristics have been linked to UTI risk in younger adults, their relevance in aged care residents remains uncertain. Methods: The faecal microbiome was assessed in 54 long-term aged care residents with a history of UTIs and 69 residents without a UTI history. Further comparisons were made to microbiome characteristics in 20 younger adults without UTIs. Microbiome characteristics were examined in relation to prior and subsequent UTIs, as well as antibiotic therapy. Results: In long-term aged care residents, prior UTI history and exposure to UTI-exclusive antibiotics do not significantly affect microbiome composition or functional capacity. However, exposure to antibiotics unrelated to UTI treatment is associated with distinct microbiota compositional traits. Adjustment for dementia, incontinence, diabetes, and prior antibiotic use finds no microbiota characteristic linked to UTI development. However, prior UTI is identified as a predictor of future UTIs. Comparison with younger adults identifies greater within-participant dispersion in aged care residents, as well as lower microbiota diversity and altered microbiome functional potential. Conclusions: No association between the gut microbiome and UTI incidence, as has been reportedin younger individuals, is evident in long-termagedcare residents.Considerable variability in gutmicrobiomecharacteristics, relating tohighantibioticexposureandage-relatedphysiological and immunological factors, couldmask such a relationship.However, it cannot bediscounted that increased UTI risk in the elderly is independent of microbiome-mediated mechanisms
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© The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.