Abstract
Urinary stones and urinary tract infection (UTI) are the most common diseases in urology and they are characterized by high incidence and high recurrence rate in China. Previous studies have shown that urinary stones are closely associated with gut or urine microbiota. Calcium oxalate stones are the most common type of urinary stones. However, the profile of urinary tract microorganisms of calcium oxalate stones with UTI is not clear. In this research, we firstly found two novel clusters in patients with calcium oxalate stones (OA) that were associated with the WBC/HP (white blood cells per high-power field) level in urine. Two clusters in the OA group (OA1 and OA2) were distinguished by the key microbiota Firmicutes and Enterobacteriaceae. We found that Enterobacteriaceae enriched in OA1 cluster was positively correlated with several infection-related pathways and negatively correlated with a few antibiotics-related pathways. Meantime, some probiotics with higher abundance in OA2 cluster such as Bifidobacterium were positively correlated with antibiotics-related pathways, and some common pathogens with higher abundance in OA2 cluster such as Enterococcus were positively correlated with infection-related pathways. Therefore, we speculated that as a sub-type of OA disease, OA1 was caused by Enterobacteriaceae and the lack of probiotics compared with OA2 cluster. Moreover, we also sequenced urine samples of healthy individuals (CK), patients with UTI (I), patients with uric acid stones (UA), and patients with infection stones (IS). We identified the differentially abundant taxa among all groups. We hope the findings will be helpful for clinical treatment and diagnosis of urinary stones.
Highlights
Based on the relative abundance of microbial taxa in the oxalate stones (OA) group, we clustered the samples using a hierarchical clustering algorithm based on Euclidean distance and complete clustering method, and the result was consistent with the beta diversity plot (Figure 1C)
We focused on analyzing the urinary microbiota in the OA group and found that the high abundance bacteria in OA1 and OA2 clusters were different
Enterobacteriaceae predominated in the OA1 cluster, while the composition of highly abundant bacteria in the OA2 cluster was more diverse
Summary
Most urinary stones are composed of calcium oxalate (Evan, 2010). Ticinesi et al found that this species was negatively associated with calcium oxalate stone formation (Ticinesi et al, 2018). Liu et al found that several short-chain fatty acids (SCFAs) producing bacteria and related metabolic pathways were significantly reduced in the gut microbiota of patients with urinary stones (Liu et al, 2020). Xie et al confirmed that male patients with urinary stones had different urinary microbiome compositions and significantly lower microbial diversity than healthy subjects (Xie et al, 2020). Mouse model studies showed that Escherichia coli was associated with crystal aggregation during calcium oxalate-induced renal lesions (Barr-Beare et al, 2015). Microbiota may adhere to stone crystals by upregulating inflammatory proteins in the urine (Suen et al, 2010)
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