Michael A. Liss MD, MAS, FACS

Michael A. Liss MD, MAS, FACS
Assistant Professor of Urology
University of Texas Health San Antonio
Principal Investigator, Micro-FIRE (Microbiome of FluoroquInolone Resistant E. coli)

About My Early Stage Investigator (ESI) Grant

MY ESI grant supports the Micro-FIRE. In this study, we are investigating the microbiome in men who harbor fluoroquinolone resistant (FQR) E. coli compared to those who do not harbor the organism. FQR E. coli is the main cause of transrectal ultrasound-guided prostate biopsy needle infections.

Nearly one million biopsies are performed each year to diagnose prostate cancer, and sepsis rates have been steadily rising. We hope to understand the associated microbiome in this environment to identify pre/probiotics or other drugs to “decolonize” these men prior to prostate biopsy to reduce infection without increasing the use of antibiotics for prophylaxis.

Although, we are investigating specifically FQR E. coli as applied to prostate biopsy infection, this research could also be applied to recurrent urinary tract infections.

Along with ARLG, we are concerned that more antibiotics will be used to prevent infection leading to more resistance. We are seeking means to reduce infections by understanding the surrounding microenvironment.

Progress to Date

We have enrolled 100 men prior to prostate biopsy and have found that there is a significant E. coli overgrowth in general. There are obvious changes in those carriers vs. non-carriers. We have also identified several bacteria that are lacking from carriers that should be repopulated in future studies. We are now conducting further research to identify specific E. coli sequence types that may be targeted.

What we have learned so far is that men colonized with FQR bacteria have:

  • Less diverse bacterial communities (dysbiosis)
  • Higher levels of Enterobacteriaceae
  • Reduced levels of Prevotella disiens

Impact of ARLG Research Funding to My Career

 Receipt of this grant from ARLG has had a positive impact on my career and future work in the following ways:

  • I received an R03 grant from NIH AHRQ to study biopsy infection prevention with rapid diagnostics.
  • I am writing a related grant to ARLG to target decolonization of these bacteria and also a separate antibiotic stewardship project.
  • I joined our VA Antibiotic Subcommittee in charge of antibiotic resistance and stewardship and serve on the Quality Improvement Patient Safety Committee for the American Urologic Association.

Benefits of ARLG

ARLG not only provides a jump start to your funding but also opportunities to be paired with leaders in the field. This is especially helpful for someone like me who has a urology background. ARLG mentors and staff have been a phenomenal group to work with; I very much appreciate their efforts to help me along my career path.