title: Decreased microbiota diversity associated with urinary tract infection in a trial of bacterial interference.
abstract: BACKGROUND
  Patients with long-term indwelling catheters are at high risk of catheter-associated urinary tract infection (CAUTI). We hypothesized that colonizing the bladder with a benign Escherichia coli strain (E. coli HU2117, a derivative of E. coli 83972) would prevent CAUTI in older, catheterized adults.
  
  
  METHODS
  Adults with chronic, indwelling urinary catheters received study catheters that had been pre-coated with E. coli HU2117. We monitored the cultivatable organisms in the bladder for 28 days or until loss of E. coli HU2117. Urine from 4 subjects was collected longitudinally for 16S rRNA gene profiling.
  
  
  RESULTS
  Eight of the ten subjects (average age 70.9 years) became colonized with E. coli HU2117, with a mean duration of 57.7 days (median: 28.5, range 0-266). All subjects also remained colonized by uropathogens. Five subjects suffered invasive UTI, 3 febrile UTI and 2 urosepsis/bacteremia, all associated with overgrowth of a urinary pathogen. Colonization with E. coli HU2117 did not impact bacterial bladder diversity, but subjects who developed infections had less diverse bladder microbiota.
  
  
  CONCLUSIONS
  Colonization with E. coli HU2117 did not prevent bladder colonization or subsequent invasive disease by uropathogens. Microbial diversity may play a protective role against invasive infection of the catheterized bladder.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT00554996 http://clinicaltrials.gov/ct2/show/NCT00554996.
authors.affiliation: Section of Infectious Diseases, Departments of Medicine and Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.|Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Horwitz
authors.affiliation: Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: McCue
authors.affiliation: Section of Infectious Diseases, Departments of Medicine and Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Abigail C
authors.initials: AC
authors.lastname: Mapes
authors.affiliation: Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Nadim J
authors.initials: NJ
authors.lastname: Ajami
authors.affiliation: Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Petrosino
authors.affiliation: Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Ramig
authors.affiliation: Section of Infectious Diseases, Departments of Medicine and Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.|Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX, 77030, USA.
authors.forename: Barbara W
authors.initials: BW
authors.lastname: Trautner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000898:Antibiosis; D016470:Bacteremia / Q000382:microbiology; D044822:Biodiversity; D002408:Catheters, Indwelling / Q000382:microbiology; D004926:Escherichia coli / Q000235:genetics / Q000254:growth & development* / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D001743:Urinary Bladder / Q000382:microbiology*; D014546:Urinary Catheterization; D062885:Urinary Catheters / Q000382:microbiology*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D014556:Urine / Q000382:microbiology
chemical_list: D012336:RNA, Ribosomal, 16S
keywords: Biodiversity; Microbiome; Microbiota; Probiotics; Urinary tract infection