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[Urinary infections following bladder catheterization]
Insights
Prophylactic nitrofurantoin significantly reduced urinary tract infections (UTIs) after bladder catheterization during voiding cystourethrography (VCU). This preventative measure is justified for children undergoing VCU to prevent asymptomatic bacteriuria.
Area of Science:
- Urology
- Infectious Diseases
- Pediatrics
Background:
- Urinary tract infections (UTIs) are a potential complication following bladder catheterization.
- Voiding cystourethrography (VCU) involves bladder catheterization, posing a risk for UTIs.
Purpose of the Study:
- To investigate the incidence of UTIs after bladder catheterization during VCU.
- To evaluate the efficacy of prophylactic nitrofurantoin in preventing UTIs in this context.
Main Methods:
- A study involving 142 pediatric patients undergoing VCU.
- Randomized groups: 71 received prophylactic nitrofurantoin (2 mg/kg daily for 4 days), 71 received no treatment.
- Bacteriologic urine examination 4-9 days post-catheterization.
Main Results:
- Significant bacteriuria was detected in 5 of 71 untreated children (E. coli, Proteus, Klebsiella).
- No cases of significant bacteriuria were observed in the 71 children who received prophylactic nitrofurantoin.
- UTIs following VCU can be asymptomatic.
Conclusions:
- The incidence of significant bacteriuria after VCU is notable.
- Prophylactic nitrofurantoin administration is effective in preventing UTIs post-catheterization.
- Preventative antibiotic therapy is warranted for children undergoing VCU.
Abstract:
The incidence and the prophylaxis of urinary tract infection following bladder catheterization have been studied in 142 patients admitted for voiding cystourethrography (VCU). 71 children received a prophylactic treatment of 2 mg/kg nitrofurantoin daily for 4 days, while 71 received no treatment following bladder catheterization. Bacteriologic examination of the urine 4-9 days after catheterization showed significant bacteriuria in 5 untreated children. The germs responsible were E. coli, Proteus, and Klebsiella. None of the treated patients presented with significant bacteriuria. It is concluded that the incidence of significant bacteriuria after a VCU is not inconsiderable, that this urinary tract infection is often asymptomatic, and that the prophylactic administration of a disinfectant is justified.