Bacterial metagenomic analysis of patients with chronic kidney disease undergoing hemodialysis based on 16S rDNA amplicon sequencing

Chronic kidney disease (CKD) is a medical condition affecting >800 million patients globally, with end‑stage kidney disease representing the most severe stage, usually requiring dialysis as a form of renal replacement therapy. As these patients have an increased risk of sepsis‑associated mortality, and due to the limitations that arise from the use of traditional methods, prompt and accurate approaches in pathogen identification are required to ensure appropriate clinical management. The present study aimed to identify and analyze the bacterial profile of hemodialysis (HD) catheters obtained from patients with CKD who were undergoing hemodialysis using 16S ribosomal DNA (rDNA) amplicon sequencing. The present study proposed the use of the metagenomic approach in clinical laboratory settings. The results obtained in the present study revealed that the bacterial profile between site A (from the patient to the dialysis machine) and site V (from the machine back into the patient) had notable differences, with α‑ and β‑diversity indices suggesting an increased diversity at site V. In addition, analyses of the relative abundance and linear discriminant analysis effect size revealed the presence of known pathogens, including Klebsiella pneumoniae, Gardnerella vaginalis, Escherichia coli, Staphylococcus epidermidis, Acinetobacter baumannii, Corynebacterium striatum and Stenotrophomonas maltophilia. In summary, the findings of the present study highlighted the potential use of 16S rDNA amplicon sequencing as a culture‑independent alternative for determining pathogens in patients undergoing HD.