常见怀疑之外:微生物组时代新出现的泌尿系病原体

R. Moreland, Brian I. Choi, Wilson Geaman, C. Gonzalez, Baylie R. Hochstedler-Kramer, Jerrin John, Jacob Kaindl, Nikita Kesav, Jyoti Lamichhane, Luke Lucio, Malika Saxena, Aditi Sharma, Lana Tinawi, Michael E. Vanek, C. Putonti, L. Brubaker, A. Wolfe
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引用次数: 1

摘要

敏感的增强培养(元培养组)和基于培养无关DNA的(宏基因组)方法的出现揭示了人类尿路中大量的微生物物种。这个微生物群落被称为泌尿微生物组,由数百个不同的物种组成,分布在整个系统发育谱中。这一新知识与60多年前建立的标准临床微生物学实验室方法相冲突,该方法将注意力集中在公认的尿路病原体中相对较小的一部分。越来越多的报告支持这样一种假设,即这种关注范围过于狭窄。单一尿路病原体报告在复发性尿路感染(UTI)的女性中很常见,尽管她们的尿液微生物组可能会受到更广泛的破坏。标准培养报告的“无生长”患者会出现典型的“尿路感染”症状,有时抗生素会改善这些症状。元培养组学和宏基因组学方法已经反复检测到下尿路症状患者尿液样本中标准测试未检测到的挑剔、生长缓慢和/或厌氧微生物。这些微生物中的许多也在严重的非泌尿道感染中被检测到,这为它们可能是机会性病原体提供了证据。在这篇综述中,我们提出了一组鲜为人知的、新出现的和疑似的泌尿系病原体。目标是促进对这些微生物生物学的研究,重点关注它们作为共生体的生活及其向病原体的转变
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Beyond the usual suspects: emerging uropathogens in the microbiome age
The advent of sensitive enhanced culture (metaculturomic) and culture-independent DNA-based (metagenomic) methods has revealed a rich collection of microbial species that inhabit the human urinary tract. Known as the urinary microbiome, this community of microbes consists of hundreds of distinct species that range across the entire phylogenetic spectrum. This new knowledge clashes with standard clinical microbiology laboratory methods, established more than 60 years ago, that focus attention on a relatively small subset of universally acknowledged uropathogens. Increasing reports support the hypothesis that this focus is too narrow. Single uropathogen reports are common in women with recurrent urinary tract infection (UTI), although wider disruption of their urinary microbiome is likely. Typical “UTI” symptoms occur in patients with “no growth” reported from standard culture and sometimes antibiotics improve these symptoms. Metaculturomic and metagenomic methods have repeatedly detected fastidious, slow growing, and/or anaerobic microbes that are not detected by the standard test in urine samples of patients with lower urinary tract symptoms. Many of these microbes are also detected in serious non-urinary tract infections, providing evidence that they can be opportunistic pathogens. In this review, we present a set of poorly understood, emerging, and suspected uropathogens. The goal is to stimulate research into the biology of these microbes with a focus on their life as commensals and their transition into pathogens
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