Brendan Frainey, MD, on microbiome composition in patients with spina bifida

In this video, Brendan T. Frainey, MD, highlights findings from a study characterizing the diversity and composition of the urinary and intestinal microbiomes in patients with spina bifida. Frainey is a pediatric urology fellow at Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center in Nashville, Tennessee.

Video Transcript:

This study had several key findings and a lot of things that we're excited to continue pursuing. The 3 big things that we took away from this thus far are 1, that bacteria are present in the urinary microbiomes of almost all individuals with spina bifida. In the next generation sequencing, or the 16s sequencing we did, 97% of people had some bacterial growth in their urine, and 100% had it in their stool. On the specialized urine cultures that we did—these are patients that weren't having any symptoms at the time—82% of patients had bacteria growing in their urine. The notion that the urine is sterile should be hopefully abolished by now, especially in this group where we know that these individuals do have a lot of bacteria growing in their bladders. We are hoping to understand how that contributes to their overall health.

The second big thing is that in their microbiomes, E coli was a major player. That's a common bug that leads to urinary tract infections. It was the most common organism we found and the most abundant. We looked at all the organisms in their microbiomes or the things that grew on urine culture, and we found that E coli was the dominant organism. In addition to that, we realized that there wasn't a ton of diversity in the microbiomes. These individuals often only had 1 or 2 bacteria that were dominating the whole microbiome, which is very different from a typical individual who has a lot of other what we call commensal bacteria that may be contributing to their health. We don't necessarily know what that means yet, but we know that there's not much diversity in the microbiomes of these individuals, which [may] play a [role] in why they get recurrent UTIs.

Then the final thing, which isn't that surprising, but we proved for the first time, was that patients who catheterize their bladder—a lot of individuals with spina bifida catheterize to empty their bladder—have higher proportions of skin flora growing and living in their bladder. Staphylococcus aureus is one of the common bacteria that lives on our skin and our hands. We took hand swaps and showed that that was more common in individuals that catheterize than those that didn't. It's something that we've presumed, because they're using their hands to catheterize themselves, but we've now shown. Hopefully down the line, we can say, if this bacteria might be growing and they don't have symptoms, that's expected. We shouldn't be treating individuals with spina bifida that have some of these common skin flora in their bladder if they're not having symptoms of a UTI or fevers. I think that'll be helpful to show and to prove down the line.

This transcript was AI generated and edited by human editors for clarity.