Urobiome status in children with vesicoureteral reflux. A review
- Authors: Turov F.O.1, Yatsyk S.P.2,3, Vrublevskiy S.G.1,4, Krapivkin A.I.1,4, Korovin S.A.3,5
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Affiliations:
- Scientific and Practical Center of Specialized Medical Care for Children
- National Medical Research Center for Children's Health
- Russian Medical Academy of Continuous Professional Education
- Pirogov Russian National Research Medical University (Pirogov University)
- Bashlyaeva Children's City Clinical Hospital
- Issue: No 1 (2025)
- Pages: 19-22
- Section: Articles
- URL: https://pediatria.orscience.ru/2658-6630/article/view/678084
- DOI: https://doi.org/10.26442/26586630.2025.1.203059
- ID: 678084
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Abstract
Vesicoureteral reflux (VUR) is the main precipitating factor of urinary tract infection (UTI) in children and one of the most debatable and common diseases in pediatric urology and nephrology. The article analyzes foreign publications on the urinary microbiome in children with VUR. Despite disagreements over non-surgical treatment of VUR, continuous antibiotic prophylaxis, which is prescribed for a long time at a prophylactic dosage, is currently considered the standard of care for young children with VUR of varying grades. The urinary microbiome research is at its early stage. Like the gut microbiome, the UT microbiome (urobiome) is formed from the first days of life. One of the most significant factors that can disrupt the development of a healthy microbiome is the use of antibiotics prescribed to children during the first years of life in various dosages for a long time. The study of their effect on the microbial architecture of the gut and the overall microbiome is becoming a key priority of modern research. The primary source of the microbiome is the environment and the intestine. Studies of the change in the composition of the microbiome in young children with VUR who received non-surgical treatment with continuous antibiotic prophylaxis have demonstrated that this group of children is prone to a high concentration of enterobacteria, such as Klebsiella spp. and Escherichia coli, which increases the risk of exacerbation of UT inflammatory diseases.
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About the authors
Filipp O. Turov
Scientific and Practical Center of Specialized Medical Care for Children
Author for correspondence.
Email: Filipp_100@mail.ru
ORCID iD: 0000-0002-9301-7586
Cand. Sci. (Med.), Scientific and Practical Center of Specialized Medical Care for Children
Russian Federation, MoscowSergey P. Yatsyk
National Medical Research Center for Children's Health; Russian Medical Academy of Continuous Professional Education
Email: Filipp_100@mail.ru
ORCID iD: 0000-0001-6966-1040
D. Sci. (Med.), Prof., Corr. Memb. RAS
Russian Federation, Moscow; Moscow
Sergey G. Vrublevskiy
Scientific and Practical Center of Specialized Medical Care for Children; Pirogov Russian National Research Medical University (Pirogov University)
Email: Filipp_100@mail.ru
ORCID iD: 0000-0001-9400-7673
D. Sci. (Med.), Prof.
Russian Federation, Moscow; MoscowAlexey I. Krapivkin
Scientific and Practical Center of Specialized Medical Care for Children; Pirogov Russian National Research Medical University (Pirogov University)
Email: Filipp_100@mail.ru
ORCID iD: 0000-0002-4653-9867
D. Sci. (Med.)
Russian Federation, Moscow; Moscow
Sergey A. Korovin
Russian Medical Academy of Continuous Professional Education; Bashlyaeva Children's City Clinical Hospital
Email: Filipp_100@mail.ru
ORCID iD: 0000-0002-8030-9926
D. Sci. (Med.)
Russian Federation, Moscow; MoscowReferences
- Bailey R. Vesicoureteric reflux in healthy infants and children. In: Hodson J, Kincaid-Smith P. Masson. Reflux Nephropathy. New York, 1979.
- Khoury AE, Bagli DJ. Vesicoureteral Reflux. Campbell-Walsh Urology. Vol. 4, 10th ed. Philadelphia: Saunders, 2011.
- Peters CA, Skoog SJ, Arant BS Jr, et al. Summary of the AUA Guideline on Management of Primary Vesicoureteral Reflux in Children. J Urol. 2010;184(3):1134-44. doi: 10.1016/j.juro.2010.05.065
- Tullus K. Vesicoureteric reflux in children. Lancet. 2015;385(9965):371-9. doi: 10.1016/S0140-6736(14)60383-4
- Morello W, La Scola C, Alberici I, Montini G. Acute pyelonephritis in children. Pediatr Nephrol. 2016;31(8):1253-65. doi: 10.1007/s00467-015-3168-5
- Montini G, Tullus K, Hewitt I. Febrile urinary tract infections in children. N Engl J Med. 2011;365(3):239-50. doi: 10.1056/NEJMra1007755
- Hufnagel M, Versporten A, Bielicki J, et al. High Rates of Prescribing Antimicrobials for Prophylaxis in Children and Neonates: Results from the Antibiotic Resistance and Prescribing in European Children Point Prevalence Survey. J Pediatric Infect Dis Soc. 2019;8(2):143-51. doi: 10.1093/jpids/piy019
- Cho I, Blaser MJ. The human microbiome: at the interface of health and disease. Nat Rev Genet. 2012;13(4):260-70. doi: 10.1038/nrg3182
- Li J, Jia H, Cai X, et al. An integrated catalog of reference genes in the human gut microbiome. Nat Biotechnol. 2014;32(8):834-41. doi: 10.1038/nbt.2942
- Frank DN, St Amand AL, Feldman RA, et al. Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseases. Proc Natl Acad Sci USA. 2007;104(34):13780-5. doi: 10.1073/pnas.0706625104
- Gevers D, Kugathasan S, Denson LA, et al. The treatment-naive microbiome in new-onset Crohn's disease. Cell Host Microbe. 2014;15(3):382-92. doi: 10.1016/j.chom.2014.02.005
- Ni J, Shen TD, Chen EZ, et al. A role for bacterial urease in gut dysbiosis and Crohn's disease. Sci Transl Med. 2017;9(416). doi: 10.1126/scitranslmed.aah6888
- Захарова И.Н., Оробинская Я.В., Бережная И.В., и др. Почему педиатра интересует вопрос, родился ли ребенок естественным путем или с помощью операции кесарева сечения? Педиатрия. Consilium Medicum. 2024;1:8-14 [Zakharova IN, Orobinskaya YaV, Berezhnaya IV, et al. Why does it matter to the pediatrician whether the baby was born naturally or by Cesarean section? A review. Pediatrics. Consilium Medicum. 2024;1:8-14 (in Russian)]. doi: 10.26442/26586630.2024.1.202613
- Cox LM, Yamanishi S, Sohn J, et al. Altering the intestinal microbiota during a critical developmental window has lasting metabolic consequences. Cell. 2014;158(4):705-21. doi: 10.1016/j.cell.2014.05.052
- Koenig JE, Spor A, Scalfone N, et al. Succession of microbial consortia in the developing infant gut microbiome. Proc Natl Acad Sci USA. 2011;108(Suppl. 1):4578-85. doi: 10.1073/pnas.1000081107
- Wolfe AJ, Brubaker L. "Sterile Urine" and the Presence of Bacteria. Eur Urol. 2015;68(2):173-4. doi: 10.1016/j.eururo.2015.02.041
- Hilt EE, McKinley K, Pearce MM, et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014;52(3):871-6. doi: 10.1128/JCM.02876-13
- Perez-Carrasco V, Soriano-Lerma A, Soriano M, et al. Urinary Microbiome: Yin and Yang of the Urinary Tract. Front Cell Infect Microbiol. 2021;11:617002. doi: 10.3389/fcimb.2021.617002
- Karstens L, Asquith M, Davin S, et al. Does the Urinary Microbiome Play a Role in Urgency Urinary Incontinence and Its Severity? Front Cell Infect Microbiol. 2016;6:78. doi: 10.3389/fcimb.2016.00078
- Pearce MM, Hilt EE, Rosenfeld AB, et al. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. mBio. 2014;5(4):e01283-14. doi: 10.1128/mBio.01283-14
- van der Zee A, Roorda L, Bosman G, Ossewaarde JM. Molecular Diagnosis of Urinary Tract Infections by Semi-Quantitative Detection of Uropathogens in a Routine Clinical Hospital Setting. PLoS One. 2016;11(3):e0150755. doi: 10.1371/journal.pone.0150755
- Atay N, Uslu Gökceoğlu A. Evaluation of urinalysis and urine culture in children with first-time urinary tract infection. Turk J Urol. 2021;47(3):242-4. doi: 10.5152/tud.2020.20387
- Hoffman C, Siddiqui NY, Fields I, et al. Species-Level Resolution of Female Bladder Microbiota from 16S rRNA Amplicon Sequencing. mSystems. 2021;6(5):e0051821. doi: 10.1128/mSystems.00518-21
- Shevchenko SG, Radey M, Tchesnokova V, et al. Escherichia coli Clonobiome: Assessing the Strain Diversity in Feces and Urine by Deep Amplicon Sequencing. Appl Environ Microbiol. 2019;85(23). doi: 10.1128/AEM.01866-19
- Lewis DA, Brown R, Williams J, et al. The human urinary microbiome; bacterial DNA in voided urine of asymptomatic adults. Front Cell Infect Microbiol. 2013;3:41. doi: 10.3389/fcimb.2013.00041
- Siddiqui H, Nederbragt AJ, Lagesen K, et al. Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol. 2011;11:244. doi: 10.1186/1471-2180-11-244
- Kinneman L, Zhu W, Wong WSW, et al. Assessment of the Urinary Microbiome in Children Younger Than 48 Months. Pediatr Infect Dis J. 2020;39(7):565-70. doi: 10.1097/INF.0000000000002622
- Fredsgaard L, Thorsteinsson K, Bundgaard-Nielsen C, et al. Description of the voided urinary microbiota in asymptomatic prepubertal children – A pilot study. J Pediatr Urol. 2021;17(4):545.e1-4.e8. doi: 10.1016/j.jpurol.2021.03.019
- Vitko D, McQuaid JW, Gheinani AH, et al. Urinary Tract Infections in Children with Vesicoureteral Reflux are Accompanied by Alterations in Urinary Microbiota and Metabolome Profiles. Eur Urol. 2022;81(2):151-5. doi: 10.1016/j.eururo.2021.08.022
- Kelly MS, Dahl EM, Jeries LM, et al. Characterization of pediatric urinary microbiome at species-level resolution indicates variation due to sex, age, and urologic history. J Pediatr Urol. 2024;20(5):884-93. doi: 10.1016/j.jpurol.2024.05.016
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