Gut microbiota and urobiota in liver cirrhosis with urinary tract infections

The purpose of the study was to examine the differences and commonality of the gut microbiota and urobiota in patients with liver cirrhosis (LC), depending on the presence of urinary tract infections (UTI).

Material and methods. A prospective cohort study was conducted on 125 patients with LC, including 41 — without UTI, 22 — with asymptomatic bacteriuria (ABU), and 62 — with UTI.

The results and their discussion. The beta diversity of the gut microbiota and urobiota differs in LC without UTI, with ABU, and with UTI (p = 0.002 and p = 0.001). In the gut microbiota in LC without UTI — with ABU — with UTI, there is an increase in the abundance of Pseudomonadota taxa (1.25 [0.49; 3.15]% — 5.76 [1.34; 10.29]% — 6.40 [1.78; 31.23]%, p = 0.0003), Gammaproteobacteria (0.57 [0.05; 2.59]% — 4.06 [0.63; 7.16]% — 4.47 [0.9; 29.82]%, p = 0.0004), Bacilli (2.52 [1.28; 7.96]% — 6.75 [2.51; 15.91]% — 13.86 [3.5; 26.52]%, p = 0.006) and decreased Bacteroidota density (42.94 [31.77; 67.78]% without UTI, 25.38 [0.95; 44.58]% with UTI, p = 0.003). Urobiota in LC without UTI — with ABU — with UTI are characterized by an increase in Pseudomonadota taxa (68.48 [38.7; 90.69]% — 71,57 [20,3; 88,4]% — 80.51 [8.85; 93.07]%, p = 0.029), Gammaproteobacteria (33.59 [26.5; 48.95]% — 38.95 [14.08; 78.94]% — 52.8 [5.25; 86.88]%, p = 0.004) and a decrease in Actinomycetota (2.89 [1.24; 5.59]% — 1.63 [0.22; 4.08]% — 0.5 [0.08; 3.8]%, р = 0.03), Clostridia (0.94 [0.07; 2.36]% — 0.4 [0.06; 5.98]% — 0.24 [0.03; 0.93]%, p = 0.011). The commonality between the urobiota and the gut microbiota in patients with LC with UTI ranges from 96% at the department level to 61.5% at the species level.

Conclusion. In patients with LC with UTI, there is a change in the beta diversity of the gut microbiota and urobiota, an increase in the abundance of pathogenic taxa (Pseudomonadota, Gammaproteobacteria, Bacilli), and a decrease in the abundance of commensal taxa (Bacteroidota, Actinomycetota, Clostridia) compared to the group without UTI.

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