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Urinary tract infections in children with spina bifida: an inventory of 41 European centers

Bas S H J Zegers1, Pauline L H Winkler-Seinstra, Cuno S P M Uiterwaal

  • 1Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. b.zegers@mmc.nl

Pediatric Nephrology (Berlin, Germany)
|December 11, 2008
PubMed

Insights

Treatments for neurogenic bladder sphincter dysfunction (NBSD) in children with spina bifida (SB) have improved renal function. However, a European survey reveals a lack of consensus on preventing, diagnosing, and treating urinary tract infections (UTIs) and managing clean intermittent catheterization (CIC).

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Neurology

Background:

  • Advances in clean intermittent catheterization (CIC), low-dose chemoprophylaxis (LDCP), anticholinergic medication, and urological surgery have improved renal function in children with neurogenic bladder sphincter dysfunction (NBSD) due to spina bifida (SB).
  • Despite these advancements, urinary tract infections (UTIs) remain a significant concern for long-term renal health in this population.

Purpose of the Study:

  • To survey European centers regarding their protocols for diagnosing and treating UTIs in children with NBSD.
  • To identify variations and potential gaps in current management strategies for UTIs and CIC in pediatric NBSD patients across Europe.

Main Methods:

  • A web-based questionnaire was distributed to 41 centers across 14 European countries.
  • The survey collected data on diagnostic and treatment protocols for UTIs and practices related to CIC in children with NBSD.

Main Results:

  • Most surveyed centers reported having standardized protocols for treating UTIs.
  • However, significant discrepancies were found in protocols for UTI prevention, diagnosis, and treatment among European centers.
  • There was also a lack of consensus regarding the management of CIC in children with NBSD.

Conclusions:

  • While treatment protocols for established UTIs are common, European centers lack consensus on comprehensive UTI management strategies (prevention, diagnosis, treatment) and CIC protocols for pediatric NBSD patients.
  • This variability highlights a need for standardized guidelines to optimize care and long-term outcomes for children with NBSD and spina bifida.

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