Asymptomatic bacteriuria rates in schoolchildren: results from a rural city in Turkey
1Department of Clinic Microbiology and Infectious Diseases, Süleyman Demirel University, Medical School, Turkey.
Insights
Asymptomatic bacteriuria (ABU) affects 0.37% of schoolchildren in Isparta, Turkey, with higher rates in girls. Most cases resolve spontaneously, suggesting ABU may not require routine treatment in this population.
Area of Science:
- Pediatrics
- Infectious Diseases
- Urology
Background:
- Asymptomatic bacteriuria (ABU) treatment is condition-specific, and screening is not generally recommended for healthy children.
- Previous studies indicated a high prevalence of ABU in infants in eastern Turkey.
- This prompted an investigation into ABU rates among schoolchildren in Isparta, Turkey.
Purpose of the Study:
- To determine the prevalence of asymptomatic bacteriuria (ABU) in schoolchildren aged 6-14 years in Isparta, Turkey.
- To identify bacterial agents causing ABU and observe ABU resolution rates.
- To compare ABU prevalence between genders and discuss potential contributing factors.
Main Methods:
- A voluntary screening of 10,289 schoolchildren (aged 6-14) from 14 schools in Isparta, Turkey.
- Two clean-catch midstream urine samples were collected and analyzed via microscopy and culture.
- Bacterial agents were identified using Gram's stain; urological/radiological referrals were made for positive cases.
Main Results:
- The overall prevalence of ABU was 0.37% (38 out of 10,289 children).
- ABU prevalence was significantly higher in girls (0.67%) compared to boys (0.08%).
- Escherichia coli was the most common pathogen (79% of cases). ABU resolved spontaneously in 71.1% of children within one year.
Conclusions:
- The prevalence of ABU in schoolchildren in Isparta is low and consistent with existing literature.
- The high spontaneous resolution rate suggests that routine screening and treatment for ABU may not be necessary in this demographic.
- Lower ABU prevalence in boys could be associated with high circumcision rates in Turkey.
Abstract:
Although the treatment of asymptomatic bacteriuria (ABU) is recommended in certain conditions, and screening for ABU is generally not recommended in healthy children, high prevalence of ABU in infants in a former study from eastern Turkey, led us to conduct a study to discover ABU rates in schoolchildren in the province of Isparta, Turkey. Children (n = 10289) from 14 schools and aged 6-14 years participated voluntarily. Two clean-catch midstream urine samples were collected, and screened by microscope and culture for infection. Bacterial agents were identified by Gram's stain. Urological and radiological examinations were suggested to the parents of the children identified with ABU. Five thousand and seventy three participants (49.3 per cent) were girls and 5216 (50.7 per cent) were boys. The median age was 10 (6-14) years. The prevalence of ABU in the total population was 0.37 per cent. The prevalence for ABU was higher in female students 134 (0.67 per cent) vs. 4 (0.08 per cent)], [x 2 (df = 1) = 24.44, p < 0.01]. A decline of ABU from the first to the second screening was observed. In 30 (79 per cent) children with ABU, Escherichia coli was isolated. One year later 27 (71.1 per cent) of the 38 children with ABU were found to be culture negative. The prevalence of ABU in our sample population was consistent with the literature. Lower prevalence of ABU in boys may be linked to the high circumcision frequency in Turkey.
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