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Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction
Nader Shaikh1, Alejandro Hoberman2, Ron Keren3
1Divisions of General Academic Pediatrics, and nader.shaikh@chp.edu.
Pediatrics
|December 10, 2015
Summary
Children with bladder and bowel dysfunction (BBD) and vesicoureteral reflux (VUR) face higher recurrent urinary tract infection (UTI) risks. Antimicrobial prophylaxis significantly benefits these children.
Area of Science:
- Pediatric Urology
- Clinical Pediatrics
- Child Health Outcomes
Background:
- Limited data exists on outcomes for children with bladder and bowel dysfunction (BBD) post-urinary tract infection (UTI).
- Understanding BBD's impact on children with and without vesicoureteral reflux (VUR) is crucial.
Purpose of the Study:
- To characterize clinical features of children with BBD.
- To evaluate BBD's effect on patient outcomes, considering the presence or absence of VUR.
Main Methods:
- Combined data from two longitudinal studies of children under 6 with a first/second UTI, followed for 2 years.
- Compared outcomes (recurrent UTIs, renal scarring, surgery, VUR resolution, treatment failure) between children with and without BBD and VUR.
Main Results:
- 54% of toilet-trained children had BBD at baseline; 94% reported daytime wetting, withholding, or constipation.
- Children with both BBD and VUR (not on prophylaxis) had a 51% recurrent UTI rate versus 20-35% for other groups.
- BBD was not linked to other investigated outcomes.
Conclusions:
- Children with both BBD and VUR have a significantly higher risk of recurrent UTIs.
- These children demonstrate the greatest benefit from antimicrobial prophylaxis.
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