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Effect of cranberry juice on bacteriuria in children with neurogenic bladder receiving intermittent catheterization
T A Schlager1, S Anderson, J Trudell
1University of Virginia, Department of Pediatrics and Emergency Medicine, Charlottesville 22906-0014, USA.
Insights
Cranberry concentrate did not reduce bacteriuria or symptomatic urinary tract infections in children with neurogenic bladder undergoing clean intermittent catheterization. The study found no significant difference in infection rates between cranberry and placebo groups.
Area of Science:
- Urology
- Pediatrics
- Infectious Diseases
Background:
- Neurogenic bladder affects children, increasing risks of urinary tract issues.
- Clean intermittent catheterization (CIC) is common but can lead to bacteriuria and infections.
- Preventive strategies for urinary tract infections (UTIs) in this population are crucial.
Purpose of the Study:
- To evaluate cranberry concentrate's efficacy in preventing bacteriuria and symptomatic UTIs.
- To assess the impact of cranberry prophylaxis in pediatric patients with neurogenic bladder on CIC.
- To determine if cranberry concentrate alters urine pH or pathogen prevalence.
Main Methods:
- A double-blind, placebo-controlled, crossover study was conducted over 6 months.
- 15 children with neurogenic bladder on CIC received either cranberry or placebo concentrate for 3 months each.
- Urine samples were collected weekly via CIC, and UTI symptoms/medications were recorded.
Main Results:
- Bacteriuria rates remained high (75%) during both placebo and cranberry concentrate consumption.
- No significant difference was observed in the frequency of bacteriuria or symptomatic UTIs between groups.
- Escherichia coli was the predominant pathogen, and urine acidification showed no significant change.
Conclusions:
- Cranberry concentrate demonstrated no effect on reducing bacteriuria in children with neurogenic bladder on CIC.
- The high prevalence of bacteriuria (70%) in this population persists despite cranberry intervention.
- Further research may be needed to explore alternative UTI prevention strategies for this vulnerable group.
Objective:
To determine the effect of cranberry prophylaxis on rates of bacteriuria and symptomatic urinary tract infection in children with neurogenic bladder receiving clean intermittent catheterization.
Design:
Double-blind, placebo-controlled, crossover study of 15 children receiving cranberry concentrate or placebo concentrate for 6 months (3 months receiving one concentrate, followed by 3 months of the other). Weekly home visits were made. During each visit, a sample of bladder urine was obtained by intermittent catheterization. Signs and symptoms of urinary tract infection and all medications were recorded, and juice containers were counted.
Results:
During consumption of cranberry concentrate, the frequency of bacteriuria remained high. Cultures of 75% (114 of 151) of the 151 samples obtained during consumption of placebo were positive for a pathogen (>/=10(4) colony-forming units/mL) compared with 75% (120 of 160) of the 160 samples obtained during consumption of cranberry concentrate. Escherichia coli remained the most common pathogen during placebo and cranberry periods. Three symptomatic infections each occurred during the placebo and cranberry periods. No significant difference was observed in the acidification of urine in the placebo group versus the cranberry group (median, 5.5 and 6.0, respectively).
Conclusion:
The frequency of bacteriuria in patients with neurogenic bladder receiving intermittent catheterization is 70%; cranberry concentrate had no effect on bacteriuria in this population.