title: The Interaction between Enterobacteriaceae and Calcium Oxalate Deposits.
abstract: BACKGROUND
  The role of calcium oxalate crystals and deposits in UTI pathogenesis has not been established. The objectives of this study were to identify bacteria present in pediatric urolithiasis and, using in vitro and in vivo models, to determine the relevance of calcium oxalate deposits during experimental pyelonephritis.
  
  
  METHODS
  Pediatric kidney stones and urine were collected and both cultured and sequenced for bacteria. Bacterial adhesion to calcium oxalate was compared. Murine kidney calcium oxalate deposits were induced by intraperitoneal glyoxalate injection and kidneys were transurethrally inoculated with uropathogenic Escherichia coli to induce pyelonephritis.
  
  
  RESULTS
  E. coli of the family Enterobacteriaceae was identified in patients by calcium oxalate stone culture. Additionally Enterobacteriaceae DNA was sequenced from multiple calcium oxalate kidney stones. E. coli selectively aggregated on and around calcium oxalate monohydrate crystals. Mice inoculated with glyoxalate and uropathogenic E. coli had higher bacterial burdens, increased kidney calcium oxalate deposits and an increased kidney innate immune response compared to mice with only calcium oxalate deposits or only pyelonephritis.
  
  
  CONCLUSIONS
  In a murine model, the presence of calcium oxalate deposits increases pyelonephritis risk, likely due to preferential aggregation of bacteria on and around calcium oxalate crystals. When both calcium oxalate deposits and uropathogenic bacteria were present, calcium oxalate deposit number increased along with renal gene transcription of inner stone core matrix proteins increased. Therefore renal calcium oxalate deposits may be a modifiable risk factor for infections of the kidney and urinary tract. Furthermore, bacteria may be present in calcium oxalate deposits and potentially contribute to calcium oxalate renal disease.
authors.affiliation: The Research Institute at Nationwide Children's Hospital, Center for Clinical and Translational Research, Columbus, Ohio, United States of America.
authors.forename: Evan
authors.initials: E
authors.lastname: Barr-Beare
authors.affiliation: The Research Institute at Nationwide Children's Hospital, Center for Clinical and Translational Research, Columbus, Ohio, United States of America.
authors.forename: Vijay
authors.initials: V
authors.lastname: Saxena
authors.affiliation: Loyola University Chicago, Stritch School of Medicine, Department of Microbiology and Immunology, Chicago, Illinois, United States of America.
authors.forename: Evann E
authors.initials: EE
authors.lastname: Hilt
authors.affiliation: Loyola University Chicago, Stritch School of Medicine, Department of Microbiology and Immunology, Chicago, Illinois, United States of America.
authors.forename: Krystal
authors.initials: K
authors.lastname: Thomas-White
authors.affiliation: Nationwide Children's Hospital, Division of Urology, Columbus, Ohio, United States of America.
authors.forename: Megan
authors.initials: M
authors.lastname: Schober
authors.affiliation: The Research Institute at Nationwide Children's Hospital, Center for Clinical and Translational Research, Columbus, Ohio, United States of America.
authors.forename: Birong
authors.initials: B
authors.lastname: Li
authors.affiliation: The Research Institute at Nationwide Children's Hospital, Center for Clinical and Translational Research, Columbus, Ohio, United States of America; Nationwide Children's Hospital, Division of Nephrology, Columbus, Ohio, United States of America.
authors.forename: Brian
authors.initials: B
authors.lastname: Becknell
authors.affiliation: Lebonheur Children's Hospital, Division of Nephrology, Memphis, Tennessee, United States of America.
authors.forename: David S
authors.initials: DS
authors.lastname: Hains
authors.affiliation: Loyola University Chicago, Stritch School of Medicine, Department of Microbiology and Immunology, Chicago, Illinois, United States of America.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wolfe
authors.affiliation: Loyola University Chicago, Stritch School of Medicine, Department of Microbiology and Immunology, Chicago, Illinois, United States of America; Nationwide Children's Hospital, Division of Nephrology, Columbus, Ohio, United States of America.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Schwaderer
mesh_terms: D000293:Adolescent; D000818:Animals; D002129:Calcium Oxalate / Q000378:metabolism*; D002648:Child; D004269:DNA, Bacterial / Q000737:chemistry; D004195:Disease Models, Animal; D004755:Enterobacteriaceae / Q000235:genetics / Q000378:metabolism*; D004926:Escherichia coli / Q000235:genetics / Q000378:metabolism; D005260:Female; D006038:Glyoxylates / Q000008:administration & dosage; D006801:Humans; D007668:Kidney / Q000276:immunology / Q000378:metabolism; D007669:Kidney Calculi / Q000209:etiology / Q000378:metabolism / Q000382:microbiology; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D011704:Pyelonephritis / Q000209:etiology; D012336:RNA, Ribosomal, 16S / Q000737:chemistry / Q000235:genetics; D012307:Risk Factors; D017422:Sequence Analysis, DNA; D052878:Urolithiasis / Q000209:etiology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D006038:Glyoxylates; D012336:RNA, Ribosomal, 16S; D002129:Calcium Oxalate; C031150:glyoxylic acid