Probiotics prophylaxis in pyelonephritis infants with normal urinary tracts

Area of Science:

• Pediatric Nephrology
• Microbiology
• Infectious Diseases

Background:

• Pyelonephritis in infants can lead to renal scarring, emphasizing the need for effective prophylaxis.
• Recurrent pyelonephritis necessitates preventative strategies to avoid long-term renal damage.

Purpose of the Study:

• To compare the efficacy of probiotic, antibiotic, and no-prophylaxis in infants diagnosed with pyelonephritis and a normal urinary tract.
• To evaluate the impact of different prophylaxis methods on recurrent urinary tract infections (UTIs) and causative pathogens.

Main Methods:

• A retrospective evaluation of 191 infants with acute pyelonephritis and normal urinary tracts, followed for 6 months.
• Infants were divided into three groups: probiotic (Lactobacillus), antibiotic (trimethoprim/sulfamethoxazole), and no-prophylaxis.
• Comparison of recurrent UTI incidence, main uropathogens, and antimicrobial sensitivities.

Main Results:

• Recurrent UTI incidence was 8.2% in the probiotic group, significantly lower than 20.6% in the no-prophylaxis group (P=0.035).
• Probiotic prophylaxis showed no significant difference compared to antibiotic prophylaxis (10.0%, P=0.532).
• Escherichia coli remained the primary pathogen; however, E. coli resistance to trimethoprim/sulfamethoxazole was 100% in the antibiotic group versus 25.0% in the probiotic group (P=0.008).

Conclusions:

• Probiotic prophylaxis is more effective than no-prophylaxis in infants with pyelonephritis and normal urinary tracts.
• Probiotics represent a viable natural alternative to antibiotic prophylaxis for managing infant pyelonephritis.
• The study highlights the potential of probiotics in reducing antibiotic resistance associated with UTI treatment.