Gut microbiota dysbiosis as a predictive factor of staghorn calculus formation

Introduction: The annual prevalence of urolithiasis is 3-5% and the approximate lifetime prevalence is 15-25%. Recurrence rates of urolithiasis are approximately 10% in a year, 50% over a period of 5-10 years, and 75% over a 20-year period despite current treatment. Correlation between gut microbiota and urolithiasis has been studied with inconsistent findings. Materials and method: This is a single-centre, prospective case-control study conducted from June 2022 till January 2024 to study gut microbiota profile in staghorn calculus and healthy individual. A total of 60 patients recruited into the study, 30 patients with staghorn calculus were enrolled into disease group and 30 healthy participants without urolithiasis were enrolled into control group. Urine samples were collected to send for cultures, while fecal samples were collected to send for microbiota DNA analysis. Results: At phylum level, staghorn group have more abundant Proteobacteria (14.2%) and Bacteroidota (4.2%) versus control group 2.8% and 0.4% respectively. At species level, staghorn group has more abundant Escherichia 11.8% versus non-staghorn group 2.5%, meanwhile control group has more abundant Bifidobacterium adolescentis 11.3% versus staghorn group 1.8%. The alpha diversity showed species richness is significant difference between staghorn group and control group, where control group has reduced diversity compared to staghorn group. The beta diversity shows dissimilarity of microbiota composition between staghorn group and control group. LEfSe analysis confirmed that Megamonas funiformis was the most enriched in staghorn patients (LDA score -4.19), while Bifidobacterium adolescentis was the most enriched species found in control group (LDA score 3.9). Conclusion: This study found that gut microbiota of patient with staghorn calculus is different from the control group (healthy group), support the relation of dysbiosis gut microbiota with staghorn calculus formation. Megamonas funiformis is the most abundant species found in patient with staghorn stone.