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Oxalobacter formigenes

Hyperoxaluria is a disorder characterized by increased urinary oxalate (calcium salt of oxalic acid) excretion. Primary hyperoxaluria is an inherited defect of oxalate metabolism while secondary hyperoxaluria is seen in states of increased ingestion of oxalate, its precursors (vitamin C) or altered gut flora. These disorders can lead to recurrent kidney stones, nephrocalcinosis (deposition of calcium salts in the kidneys) and eventually end stage renal disease.3

Oxalobacter formigenes is a gram-negative anaerobic, rod or curve shaped, non-motile, non-spore forming bacterium that belongs to the Betaproteobacteria class and Burkholderiales order. It colonizes the colon of a substantial proportion of the animals, including humans, and metabolizes dietary and endogenous oxalate. Oxalobacter formigenes has become medically important because of its capacity to degrade crystalline as well as soluble oxalate.2 The bacterium has been associated with a large reduction in the odds of 70% reduction in the odds of a recurrence of calcium oxalate stones calcium oxalate kidney stones. Over 13% of American men and 7% of American women will experience a renal stone over the course of a lifetime. Thus, the public health implications of this relationship are potentially large.1 Considerable evidence indicates that Oxalobacter formigenes is the primary organism that degrades oxalate in the colon. Although Lactobacillus and Bifidobacterium, are also capable of consuming oxalate these other bacteria consume other substrates as well as oxalate.


Calcium oxalate stones
Source: CDC

Another benefit to the host of colonization with Oxalobacter formigenes may be due to the bacterium's ability to free up calcium ingested as calcium oxalate. Such degradation may be an important factor in enhancing calcium availability in humans with limited access to dairy products or other rich sources of calcium. The intake of antibiotics (macrolides, tetracyclines, chloramphenicol, rifampin, and metronidazole antibiotics) can result in the lower level of Oxalobacter formigenes in both cystic fibrosis patients, and calcium oxalate stone formers who are frequently prescribed antibiotics.2

References

  1. Factors Related to Colonization with Oxalobacter formigenes in U.S. Adults
  2. The genetic composition of Oxalobacter formigenes and its relationship to colonization and calcium oxalate stone disease
  3. Primary and secondary hyperoxaluria: Understanding the enigma


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