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Association between urine pH and common uropathogens in children with urinary tract infections
Huan-Cheng Lai1, Shih-Ni Chang2, Hsiao-Chuan Lin3
1Division of Pediatric Infectious Diseases, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan.
Insights
Urine pH is linked to specific bacteria causing urinary tract infections (UTIs) in children. Proteus mirabilis and Pseudomonas aeruginosa thrive in less acidic urine, while E. coli and K. pneumoniae prefer more acidic conditions.
Area of Science:
- Pediatric infectious diseases
- Clinical microbiology
- Urology
Background:
- Urinary tract infections (UTIs) are common in children.
- Understanding the relationship between urine characteristics and causative agents is crucial for effective treatment.
Purpose of the Study:
- To investigate the association between urine pH and specific uropathogens in pediatric patients.
- To determine if urine pH can predict the type of bacteria causing a UTI.
Main Methods:
- Analysis of 26,066 paired urinalysis and urine culture samples from pediatric patients.
- Classification of samples into UTI positive (6,348) and UTI negative (19,718).
- Inclusion of 5,201 UTI positive patients with single-pathogen infections, matched with 4,729 UTI negative controls.
Main Results:
- Urine pH was associated with specific uropathogens.
- Proteus mirabilis and Pseudomonas aeruginosa were linked to less acidic urine (mean pH 6.72 and 6.62).
- Escherichia coli and Klebsiella pneumoniae were associated with more acidic urine (pH 6.21 and 6.18).
- P. mirabilis prevalence increased with higher pH categories.
Conclusions:
- This is the first epidemiological study linking urine pH to specific uropathogens in pediatric UTIs.
- Both urine pH and age are associated with particular causative pathogens.
- Urine pH may play a role in predicting uropathogens, warranting further investigation.
Background/Purpose:
Urinary tract infections (UTIs) are one of the most common pediatric infections. Our objective in this study is to investigate the association between urine pH and uropathogens in pediatric patients.
Methods:
The source population comprised 26 066 paired urinalysis (UA) and urine culture (UC) samples obtained from pediatric patients. We classified the paired UA-UC samples into UTI positive (N = 6348) and UTI negative (N = 19 718) according to the colony forming units corresponding to the sampling source. We included UTI positive patients with infection caused by a single species of pathogen (N = 5201) and frequency matched them with UTI negative patients (N = 4729) by age, sex, sampling source, and visit type.
Results:
This study included 5201 pediatric patients with UTIs and found that urine with Proteus mirabilis or Pseudomonas aeruginosa demonstrated the least acidic pH (mean pH = 6.72 and 6.62, respectively), whereas urine with Escherichia coli or Klebsiella pneumoniae exhibited the most acidic pH (pH = 6.21 and 6.18). After stratifying the UTI samples by their pH range (<6, 6-6.9, 7-7.9, and ≥8). The prevalence of P. mirabilis increased significantly across increasing pH categories.
Conclusion:
This research is the first epidemiological study that linked urine pH to specific uropathogens in a pediatric population. Both urine pH and age are associated with certain causative uropathogens. Urine that grew P. mirabilis or P. aeruginosa had the least acidic pH. Additional studies should validate the role of urine pH in predicting uropathogens and UTI.
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