Title | Gastrointestinal pathogen colonization and the microbiome in asymptomatic kidney transplant recipients. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Westblade LF, Satlin MJ, Albakry S, Botticelli B, Robertson A, Alston T, Magruder M, Zhang LT, Edusei E, Chan K, Lubetzky M, Dadhania DM, Pamer EG, Suthanthiran M, Lee JR |
Journal | Transpl Infect Dis |
Volume | 21 |
Issue | 6 |
Pagination | e13167 |
Date Published | 2019 Dec |
ISSN | 1399-3062 |
Keywords | Adult, Aged, Asymptomatic Infections, Clostridioides difficile, DNA, Bacterial, Dysbiosis, Enteropathogenic Escherichia coli, Feces, Female, Gastrointestinal Microbiome, Humans, Intestinal Mucosa, Kidney Transplantation, Male, Middle Aged, Norovirus, Retrospective Studies, RNA, Ribosomal, 16S, RNA, Viral |
Abstract | BACKGROUND: In kidney transplant recipients, gastrointestinal (GI) pathogens in feces are only evaluated during diarrheal episodes. Little is known about the prevalence of GI pathogens in asymptomatic individuals in this population. METHODS: We recruited 142 kidney transplant recipients who provided a non-diarrheal fecal sample within the first 10 days after transplantation. The specimens were evaluated for GI pathogens using the BioFire FilmArray GI Panel (BioFire Diagnostics, LLC), which tests for 22 pathogens. The fecal microbiome was also characterized using 16S rRNA gene sequencing of the V4-V5 hypervariable region. We evaluated whether detection of Clostridioides difficile and other GI pathogens was associated with post-transplant diarrhea within the first 3 months after transplantation. RESULTS: Among the 142 subjects, a potential pathogen was detected in 43 (30%) using the GI Panel. The most common organisms detected were C difficile (n = 24, 17%), enteropathogenic Escherichia coli (n = 8, 6%), and norovirus (n = 5, 4%). Detection of a pathogen on the GI panel or detection of C difficile alone was not associated with future post-transplant diarrhea (P > .05). The estimated number of gut bacterial species was significantly lower in subjects colonized with C difficile than those not colonized with a GI pathogen (P = .01). CONCLUSION: Colonization with GI pathogens, particularly C difficile, is common at the time of kidney transplantation but does not predict subsequent diarrhea. Detection of C difficile carriage was associated with decreased microbial diversity and may be a biomarker of gut dysbiosis. |
DOI | 10.1111/tid.13167 |
Alternate Journal | Transpl Infect Dis |
PubMed ID | 31502737 |
PubMed Central ID | PMC6917898 |
Grant List | / / BioFire Diagnostics, LLC / P30 CA008748 / CA / NCI NIH HHS / United States R37 AI 051652 / / National Institute of Allergy and Infectious Diseases / K23 AI124464 / AI / NIAID NIH HHS / United States K23 AI 124464 / / National Institute of Allergy and Infectious Diseases / R37 AI051652 / AI / NIAID NIH HHS / United States |
Related Faculty:
Lars Westblade, Ph.D.