Ureteral Stent Microbiota Is Associated with Patient Comorbidities but Not Antibiotic Exposure

Authors

Kait F. Al, Lawson Health Research Institute
John D. Denstedt, The University of Western Ontario
Brendan A. Daisley, Lawson Health Research Institute
Jennifer Bjazevic, The University of Western Ontario
Blayne K. Welk, The University of Western Ontario
Stephen E. Pautler, The University of Western Ontario
Gregory B. Gloor, The University of Western Ontario
Gregor Reid, Lawson Health Research Institute
Hassan Razvi, The University of Western Ontario
Jeremy P. Burton, Lawson Health Research Institute

Document Type

Article

Publication Date

9-22-2020

Journal

Cell Reports Medicine

Volume

1

Issue

6

URL with Digital Object Identifier

10.1016/j.xcrm.2020.100094

Abstract

Ureteral stents are commonly used to prevent urinary obstruction but can become colonized by bacteria and encrusted, leading to clinical complications. Despite recent discovery and characterization of the healthy urinary microbiota, stent-associated bacteria and their impact on encrustation are largely underexplored. We profile the microbiota of patients with typical short-term stents, as well as over 30 atypical cases (all with paired mid-stream urine) from 241 patients. Indwelling time, age, and various patient comorbidities correlate with alterations to the stent microbiota composition, whereas antibiotic exposure, urinary tract infection (UTI), and stent placement method do not. The stent microbiota most likely originates from adhesion of resident urinary microbes but subsequently diverges to a distinct, reproducible population, thereby negating the urine as a biomarker for stent encrustation or microbiota. Urological practice should reconsider standalone prophylactic antibiotics in favor of tailored therapies based on patient comorbidities in efforts to minimize bacterial burden, encrustation, and complications of ureteral stents.