Assessment of urinary 3-indoxyl sulfate as a marker for gut microbiota diversity and abundance of Clostridiales. (4th March 2019)

• Record Type: Journal Article
• Authors: Farowski, Fedja; Els, Gregor; Tsakmaklis, Anastasia; Higgins, Paul G.; Kahlert, Christian R.; Stein-Thoeringer, Christoph K.; Bobardt, Johanna S.; Dettmer-Wilde, Katja; Oefner, Peter J.; Vehreschild, Jörg Janne; Vehreschild, Maria J.G.T.
• Is Part Of: Gut microbes. Volume 10:Isuse 2(2019)
• Page Start: 133
• Page End: 141
• Publication Date: 2019-03-04
• Subjects: microbiota -- alpha diversity -- Clostridium difficile infection -- Clostridiales -- 3-indoxyl sulfate -- biomarker; Gastrointestinal system -- Microbiology -- Periodicals; Microbiology -- Periodicals; Intestine, Small -- Periodicals; 616.3
• DOI: 10.1080/19490976.2018.1502536
• Languages: English
• ISSNs: 1949-0984

Abstract

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-allo-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.