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Assessment of the Urinary Microbiome in Children Younger Than 48 Months
Lauren Kinneman1,2,3, Wei Zhu3, Wendy S W Wong4,3
1From the Department of Pediatrics and Department of Emergency Medicine, Inova Children's Hospital, Falls Church, VA.
Insights
A urinary microbiome exists in all children, even neonates. Urinary tract infections (UTIs) in children significantly alter microbiome diversity and composition, warranting further investigation.
Area of Science:
- Pediatric Medicine
- Microbiology
- Genomics
Background:
- The urinary tract was historically considered sterile.
- Limited understanding exists regarding the pediatric urinary microbiome.
- This study investigates the urinary microbiome in young children.
Purpose of the Study:
- To characterize the urinary microbiome in children under 48 months.
- To explore associations between urinary microbiome and clinical/demographic factors.
- To identify differences in microbiome composition related to urinary tract infections (UTIs).
Main Methods:
- Recruitment of children (<48 months) undergoing urinary catheterization.
- Collection and processing of urine samples.
- 16S ribosomal RNA gene sequencing, urinalysis, and urine culture performed.
Main Results:
- A urinary microbiome was detected in all 85 participating children.
- Children with Escherichia coli UTIs showed significantly reduced alpha diversity (P < 0.001).
- Microbiome composition differed significantly between children with and without UTIs (P = 0.001).
Conclusions:
- The urinary tract harbors a microbiome in all children, including neonates.
- Culture-positive UTIs are associated with distinct urinary microbiome alterations.
- Further research is needed to understand the long-term implications of the pediatric urinary microbiome.
Background:
The urinary tract was once thought to be sterile, and little is known about the urinary microbiome in children. This study aimed to examine the urinary microbiome of young children across demographic and clinical factors.
Methods:
Children <48 months, undergoing a urinary catheterization for clinical purposes in the Pediatric Emergency Department were recruited and urine samples collected. Detailed demographic and clinical information were recorded. Urine samples underwent DNA extraction and 16S ribosomal RNA gene sequencing, urinalysis and urine culture.
Results:
Eighty-five children were included; a urinary microbiome was identified in every child. Nine children had Escherichia coli urinary tract infections (UTIs) identified. Those with UTIs had a significantly decreased alpha diversity (t test, P < 0.001) and the composition of the microbiome clustered separately (P = 0.001) compared with those without UTIs.
Conclusions:
A urinary microbiome was identified in every child, even neonates. Differences in microbiome diversity and composition were observed in patients with a standard culture positive UTI. The urinary microbiome has just begun to be explored, and the implications on long-term disease processes deserve further investigation.
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