Abstract: PD12-03
Sources of Funding: Research Institute at Nationwide Children's Hospital Clinical and Translation Research Intramural Funding Program

Introduction

Specific microbial signatures exist in the body to regulate external pathogens. While prior work has focused on the role of the adult genitourinary microbiome in urinary tract health, little research investigates the normal pediatric perineal microbiome and aberrations related to urinary tract infections (UTIs). We strove to define the genitourinary microbiome in the normal developing prepubertal female child and compared this to a small cohort of children with recurrent UTIs.

Methods

After IRB approval, we consented healthy females at pediatric well-child visits to participate. Children were divided into 4 groups of significant developmental milestones: 1) 0-3 week old newborns; 2) 5-9 month old infants transitioning to solid foods; 3) 3-5 year old toddlers undergoing toilet training; and 4) 9-12 year old premenstrual girls. We also enrolled girls from the urology clinic with a history of UTIs (>50,000 colony forming units) who have been off antibiotics >1 month. Four swabs were taken on each patient: 1) genitourinary (urethral/vaginal introitus); 2) perirectal; 3) periauricular; 4) oral. Next generation 16S rRNA sequencing was performed to identify age and location of specific microbial signatures as well as a signature associated with recurrent UTIs.

Results

A total of 40 patients were recruited: a) 13 newborns; b) 6 infants; c) 13 toddlers; d) 6 premenstrual girls; and e) 2 recurrent UTIs. Children with recurrent UTI were 15 months and 2 years old. There was a clear evolution of the perirectal and genitourinary microbiomes with age, showing divergence at 5-9 months of age. The newborn group had the tightest clustering of bacteria between perirectal and genitourinary microbiomes. Those with recurrent UTI fall outside of any age group clustering let alone their specific age group (Figure 1).

Conclusions

We are the first to describe the normal prepubertal microbiome. There is a clear divergence and personalization of perirectal and genitourinary microbiomes as early as 5-9 months of age. Likely the tight clustering of newborn perirectal and genitourinary microbiome is a result of the maternal genitourinary microbiome. Children with recurrent UTIs have a dysbiosis of their perineal microbiome compared to children without. This could represent a target of UTI prevention and/or treatment.

Funding

Research Institute at Nationwide Children's Hospital Clinical and Translation Research Intramural Funding Program