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.
| Original language | English |
|---|---|
| Article number | e13167 |
| Journal | Transplant Infectious Disease |
| DOIs | |
| Publication status | Accepted/In press - 1 Jan 2019 |
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Keywords
- Clostridioides difficile
- colonization
- diarrhea
- gastrointestinal panel
- kidney transplantation
- microbiome
ASJC Scopus subject areas
- Infectious Diseases
- Transplantation
Cite this
Gastrointestinal pathogen colonization and the microbiome in asymptomatic kidney transplant recipients. / Westblade, Lars F.; Satlin, Michael J.; Albakry, Shady; Botticelli, Brittany; Robertson, Amy; Alston, Tricia; Magruder, Matthew; Zhang, Lisa T.; Edusei, Emmanuel; Chan, Kevin; Lubetzky, Michelle; Dadhania, Darshana M.; Pamer, Eric G.; Suthanthiran, Manikkam; Lee, John R.
In: Transplant Infectious Disease, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Gastrointestinal pathogen colonization and the microbiome in asymptomatic kidney transplant recipients
AU - Westblade, Lars F.
AU - Satlin, Michael J.
AU - Albakry, Shady
AU - Botticelli, Brittany
AU - Robertson, Amy
AU - Alston, Tricia
AU - Magruder, Matthew
AU - Zhang, Lisa T.
AU - Edusei, Emmanuel
AU - Chan, Kevin
AU - Lubetzky, Michelle
AU - Dadhania, Darshana M.
AU - Pamer, Eric G.
AU - Suthanthiran, Manikkam
AU - Lee, John R.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - Clostridioides difficile
KW - colonization
KW - diarrhea
KW - gastrointestinal panel
KW - kidney transplantation
KW - microbiome
UR - http://www.scopus.com/inward/record.url?scp=85074557521&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074557521&partnerID=8YFLogxK
U2 - 10.1111/tid.13167
DO - 10.1111/tid.13167
M3 - Article
C2 - 31502737
AN - SCOPUS:85074557521
JO - Transplant Infectious Disease
JF - Transplant Infectious Disease
SN - 1398-2273
M1 - e13167
ER -