# Longitudinal Analysis of the Fecal Microbiome and Resistome of Patients with Multidrug-Resistant Urinary Tract Infections and Predictors of Recurrence

> **NIH NIH K23** · WASHINGTON UNIVERSITY · 2020 · $168,741

## Abstract

PROJECT SUMMARY/ABSTRCT
Multidrug-resistant organisms (MDRO) are major threats to human health, responsible for >2 million infections
and 23,000 deaths per year in the US alone. Urinary tract infections (UTI) are the most common types of
infections caused by MDROs. There are few options to prevent and treat MDRO UTIs, no interventions to
reverse fecal MDRO colonization, and limited strategies to identify patients at risk for recurrence. This study
will address critical barriers to scientific progress in the fields of recurrent MDRO UTI and fecal MDRO
colonization, and improve scientific knowledge by delineating the host microbial communities and MDRO traits
that are associated with MDRO colonization and recurrent UTI.
To advance my patient-oriented research career and pursue additional expertise in genomic research, I will
conduct a prospective cohort trial of patients with MDRO UTIs and characterize their stool and urine
specimens utilizing microbiologic culture and genomic techniques. We will assess longitudinal changes in the
fecal microbiome of patients with MDRO UTI utilizing metagenomic shotgun sequencing to identify microbial
taxa and functions associated with persistent MDRO colonization and recurrent UTI, and link this information
with detailed clinical data. The proposals delineated here will advance the understanding of the microbial
ecology of the fecal microbiome and its role in MDRO infections, and will provide me the opportunity to gain
knowledge and skills in study implementation, longitudinal data analysis, and genomic data analysis. I have
assembled a team of mentors and collaborators to guide my early research career and advise on the
evaluation of existing stored specimens created through a pilot study, and ongoing recruitment of patients for
the prospective cohort trial. We will analyze the specimens to answer the following questions:
1) What is the trajectory of the fecal microbiome and resistome in patients with MDRO UTIs after antimicrobial
treatment?
2) Are there taxonomic and functional compositions of the fecal microbiome associated with MDRO
 colonization and recurrent infection?
3) How does antimicrobial treatment impact the concentration of antibiotic resistance genes and bacterial
 virulence factors, and what is their relationship to recurrent MDRO UTI?
Genomic approaches and classic microbiologic techniques will be used to assess the strain types, microbial
taxa, function, and antibiotic resistance genes found in the fecal microbiome of patients with MDRO UTIs. The
culmination of these studies will provide essential data to drive the rational design of methods to detect and
prevent fecal MDRO colonization and MDRO UTIs. The findings in this study will be broadly applicable beyond
UTIs, as we will determine the relationship between fecal MDRO colonization and recurrent infections.

## Key facts

- **NIH application ID:** 9842389
- **Project number:** 5K23AI137321-02
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Jennie H Kwon
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $168,741
- **Award type:** 5
- **Project period:** 2019-03-01 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9842389

## Citation

> US National Institutes of Health, RePORTER application 9842389, Longitudinal Analysis of the Fecal Microbiome and Resistome of Patients with Multidrug-Resistant Urinary Tract Infections and Predictors of Recurrence (5K23AI137321-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9842389. Licensed CC0.

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