Urinary tract infections are one of the most common infections in humans. Here we tested the utility of urinary cell-free DNA (cfDNA) to comprehensively monitor host and pathogen dynamics in bacterial and viral urinary tract infections. We isolated cfDNA from 141 urine samples from a cohort of 82 kidney transplant recipients and performed next-generation sequencing. We found that urinary cfDNA is highly informative about bacterial and viral composition of the microbiome, antimicrobial susceptibility, bacterial growth dynamics, kidney allograft injury, and host response to infection. These different layers of information are accessible from a single assay and individually agree with corresponding clinical tests based on quantitative PCR, conventional bacterial culture, and urinalysis. In addition, cfDNA reveals the frequent occurrence of pathologies that remain undiagnosed with conventional diagnostic protocols. Our work identifies urinary cfDNA as a highly versatile analyte to monitor infections of the urinary tract.

中文翻译：

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不含尿液的DNA是监测尿路感染的通用分析物。

尿路感染是人类最常见的感染之一。在这里，我们测试了无尿DNA（cfDNA）的实用性，以全面监测细菌和病毒性尿路感染中的宿主和病原体动态。我们从来自82个肾脏移植受者队列的141个尿液样本中分离了cfDNA，并进行了下一代测序。我们发现尿cfDNA对微生物组的细菌和病毒组成，抗微生物药性，细菌生长动力学，肾脏同种异体移植物损伤以及宿主对感染的反应具有很高的信息。这些不同的信息层可通过一次测定获得，并分别基于定量PCR，常规细菌培养和尿液分析与相应的临床试验一致。此外，cfDNA揭示了经常发生的病理情况，而常规诊断方案仍无法对其进行诊断。我们的工作将尿cfDNA鉴定为监测尿路感染的高度通用的分析物。