ArticleKidney international reports2026
Urinary Microbiome Dysbiosis in Children With Congenital Uropathies at Varying Risk for Urinary Tract Infections.
Article in Kidney international reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Febrile urinary tract infections (UTIs) may occur in 30% to 50% of children with vesicoureteral reflux (VUR) or posterior urethral valves (PUVs), frequently leading to renal scarring despite chemoprophylaxis. Approximately 15% of children with uretero-pelvic junction obstruction (UPJO) may develop UTIs. However, investigations that can identify at-risk children before the first episode of UTI are lacking. In this exploratory study, we investigated the preinfection urinary microbiome in Indian children with congenital anomalies of the kidney and urinary tract (CAKUT) to determine whether microbiome alterations, metabolic potential, and antibiotic resistance profiles precede UTI. Methods: In this prospective cohort study with follow-up, urine samples were collected from 80 children: 36 with newly diagnosed, antibiotic-naïve CAKUT (18 UPJO, 12 VUR, 6 PUV) and 44 controls. Patients were stratified Results: Urinary microbial alpha diversity declined significantly from controls to low-risk to high-risk groups ( Conclusion: Children with CAKUT exhibit urinary microbiome dysbiosis before their first symptomatic UTI, characterized by loss of conserved health-associated taxa, metabolic imbalance, and broad-spectrum antibiotic resistance. These findings support the potential of microbiome-informed, noninvasive risk stratification and microbiome-tailored prophylaxis, while establishing the first Indian pediatric reference set for CAKUT-related UTI prevention.
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