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Comparison of preputial sac and urine cultures in healthy children
C Savaş1, M Cakmak, B Yorgancigil
1Department of Pediatric Surgery, Süleyman Demirel University Medical School, Isparta, Turkey. savas@tr-net-net-tr
Insights
The prepuce in male infants may harbor fecal bacteria, increasing urinary tract infection (UTI) risk. Improved hygiene after one year reduces urine contamination but doesn't change bacteria under the foreskin.
Area of Science:
- Pediatrics
- Microbiology
- Urology
Background:
- Urinary tract infections (UTIs) are common in male infants.
- The role of the subpreputial space in pediatric UTIs requires further investigation.
Purpose of the Study:
- To investigate the bacteriology of the subpreputial sac in healthy male children.
- To compare subpreputial and urine cultures.
- To assess the impact of age and penile hygiene on subpreputial and urine flora.
Main Methods:
- Simultaneous preputial sac and urine cultures were performed on 72 healthy male children, divided into two age groups.
- Bacterial isolates were identified and compared between groups and sample types.
Main Results:
- Gram-positive enteric cocci were the most frequent isolates from the subpreputial sac in the older group (Group B).
- E. coli, Enterobacter, and staphylococci were isolated from urine cultures in three patients in Group B.
- No significant difference in subpreputial bacteriology was found between age groups.
- Urine culture isolation rates were significantly higher in the younger group (Group A) compared to Group B (p < 0.05).
Conclusions:
- The prepuce may act as a reservoir for fecal bacteria, contributing to UTI pathogenesis in male infants, particularly within the first year of life.
- While improved penile hygiene after one year of age does not alter subpreputial bacteriology, it significantly reduces urine contamination.
Abstract:
The aim of the present study was to examine subpreputial bacteriology and to compare it with the urine cultures of healthy male children. Seventy-two male children were divided into two groups as A and B according to age. In both groups preputial sac and urine cultures were taken simultaneously. Gram (+) enteric cocci were the most common isolated pathogens from the preputial sac in group B. Enterobacter, E. coli and staphylococci species were isolated from the urine cultures of three patients in group B. We could not find any difference between the preputial sac swabs of group A and B patients, but the isolation rate of urine cultures of group A patients was significantly higher than group B (p < 0.05). The findings of the present study support a potential role of the prepuce acting as a reservoir of faecal bacteria in the pathogenesis of UTI in male infants, especially in the first year of life. Improved penile hygiene after the first year of life does not alter the subpreputial bacteriology, but significantly decreases the contamination of urine.
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