Assessment of urinary 3-indoxyl sulfate as a marker for gut microbiota diversity and abundance of Clostridiales

Farowski, Fedja and Els, Gregor and Tsakmaklis, Anastasia and Higgins, Paul G. and Kahlert, Christian R. and Stein-Thoeringer, Christoph K. and Bobardt, Johanna S. and Dettmer-Wilde, Katja and Oefner, Peter J. and Vehreschild, Jorg Janne and Vehreschild, Maria J. G. T. (2019) Assessment of urinary 3-indoxyl sulfate as a marker for gut microbiota diversity and abundance of Clostridiales. GUT MICROBES, 10 (2). pp. 133-141. ISSN 1949-0976, 1949-0984

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Abstract

Objectives: After allogeneic hematopoietic stem cell transplantation (allo-HCT), urinary levels of 3-indoxyl sulfate (3-IS) correlate with the relative abundance of bacteria from the class Clostridia (RAC), and antibiotic treatment is considered the major determinant of this outcome. A high RAC has been associated with favorable outcome after allo-HCT and protection from Clostridium difficile infection (CDI). We assessed correlations between alpha diversity, RAC and urinary 3-IS levels in a non-allo-HCT clinical cohort of antibiotic treated patients to further explore 3-IS as a biomarker of reduced diversity and predisposition to CDI. Methods: Fecal and urinary specimens were analyzed from 40 non-alto-HCT hospitalized patients before and 9 +/- 2 days after initiation of intravenous antibiotic treatment. Fecal microbiota were analyzed by 16s RNA sequencing and urinary 3-IS was analyzed by liquid chromatography-tandem mass spectrometry. Receiver operating characteristic (ROC) analysis was performed to assess the predictive value of 3-IS. Results: At a RAC cutoff of <30%, the binary logarithm of 3-IS (medium 3-IS: <= 2.5; high 3-IS: >2.5) was predictive with an accuracy of 82% (negative predictive value: 87%, positive predictive value 67%). Accuracy was improved by combing antibiotic history with 3-IS levels (accuracy 89%, npv 88%, ppv 92%). Conclusion: In conjunction with patient antibiotic history, 3-IS is a candidate marker to predict RAC.

Item Type: Article
Uncontrolled Keywords: DIFFICILE-ASSOCIATED DISEASE; CELL TRANSPLANT RECIPIENTS; INFECTION; EPIDEMIOLOGY; ASSOCIATION; MORTALITY; IMPACT; microbiota; alpha diversity; Clostridium difficile infection; Clostridiales; 3-indoxyl sulfate; biomarker
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Institut für Funktionelle Genomik > Lehrstuhl für Funktionelle Genomik (Prof. Oefner)
Depositing User: Dr. Gernot Deinzer
Date Deposited: 21 Apr 2020 09:36
Last Modified: 21 Apr 2020 09:36
URI: https://pred.uni-regensburg.de/id/eprint/27803

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