The gut microbiome and metabolome in children with a first febrile urinary tract infection: a pilot study
Barbora Piteková1,2,3, Ivan Hric4,5, Jakub Zieg6
1Department of Pediatric Emergency Medicine, National Institute of Children's Diseases, Bratislava, Slovakia.
Insights
Children with their first febrile urinary tract infection (fUTI) have altered gut microbiomes, showing lower diversity and beneficial bacteria. Breastfeeding duration is a key factor in predicting fUTI risk.
Area of Science:
- Pediatric Infectious Diseases
- Microbiome Research
- Gut Health and Immunity
Background:
- Febrile urinary tract infection (fUTI) is a common pediatric bacterial infection with potential severe complications.
- Emerging research suggests gut microbiome dysbiosis may contribute to fUTI development in infants.
- Understanding these microbial shifts is crucial for preventing serious health outcomes.
Purpose of the Study:
- To investigate and compare gut microbiota composition between infants experiencing their first fUTI and healthy controls.
- To identify specific microbial patterns and factors associated with fUTI onset in children.
- To explore the role of the gut microbiome in the pathogenesis of fUTI.
Main Methods:
- An observational study comparing 17 children with their first fUTI to 18 healthy controls.
- Analysis of gastrointestinal microbiome composition.
- Measurement of fecal and urinary metabolites.
Main Results:
- Children with first fUTI exhibited significantly lower gut microbial alpha-diversity (Shannon index) and reduced beneficial bacteria (short-chain fatty acids producers).
- The duration of breastfeeding was found to significantly influence gut microbiota, decreasing pathogenic bacteria and increasing beneficial taxa.
- Shannon diversity, breastfeeding duration, and specific bacteria (Faecalibacterium, Escherichia) were identified as strong predictors of fUTI.
Conclusions:
- Gut microbiome alterations are significantly associated with the occurrence of fUTI in children.
- Machine learning models identified key predictors including Shannon index, specific bacterial taxa, and breastfeeding.
- The gut microbiome shows potential as a target for fUTI prevention strategies.
Background:
Urinary tract infection (UTI) is a common bacterial infection in the pediatric population. Febrile urinary tract infection (fUTI) can lead to severe complications such as urosepsis as well as kidney scarring, chronic kidney disease, and systemic hypertension. Recent research supports the hypothesis that dysbiosis of the microbiome may play a role in the pathogenesis and development of fUTI in infants. Our main aim was to compare the shift in gut microbiota composition between children with the first fUTI and controls.
Methods:
We conducted an observational study with 17 children with the first fUTI compared to 18 healthy controls. We performed analysis of the gastrointestinal microbiome and measurements of metabolites in stool and urine.
Results:
In the gut microbiome, we found significant differences with lower α-diversity the Shannon index) and significantly lower relative abundance of probiogenic bacteria (short-chain fatty acids (SCFA)) in children with the first episode of fUTI before the start of antibiotic therapy. Furthermore, our findings confirm that the length of breastfeeding has significant influence on gut microbiota composition, reducing pathogenic bacteria and enhancing beneficial taxa. Shannon diversity, duration of breastfeeding, and specific taxa, particularly Faecalibacterium and Escherichia, emerged as strong predictors linked to the development of fUTI.
Conclusions:
This study demonstrates that gut microbiome changes are associated with the onset of fUTI in children. Machine learning models identified Shannon index, specific bacterial taxa, and breastfeeding as strong predictors of fUTI. The study highlighted the potential role of the gut microbiome in preventing fUTI.
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