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The periurethral aerobic bacterial flora in healthy boys and girls
Insights
Healthy children’s periurethral flora shifts significantly in the first year, with E. coli and enterococci diminishing. This bacterial flora variation by age and sex may inform future urinary tract infection studies.
Area of Science:
- Microbiology
- Pediatrics
- Urology
Background:
- The periurethral region's bacterial flora in children is crucial for understanding urinary tract infection (UTI) risk.
- Variations in this flora based on age and sex are not well-documented, hindering preventative strategies.
Purpose of the Study:
- To investigate the presence and variation of periurethral bacterial flora in healthy children.
- To establish a baseline for future research on UTI susceptibility in pediatric populations.
Main Methods:
- Quantitative bacterial sampling and culture techniques were employed.
- The study included 394 girls and 305 boys, aged from birth to 16 years.
Main Results:
- A dense aerobic bacterial flora, including Escherichia coli (E. coli), enterococci, and staphylococci, was established in the first few weeks of life.
- E. coli and enterococci colonization decreased significantly after the first year, becoming scanty by age 5.
- Neonatal E. coli colonization was denser in boys than girls; E. coli dominated in girls, while Proteus became common in boys after six months.
Conclusions:
- A local defense mechanism likely matures within the first year of life, protecting the periurethral area from gram-negative and enterococcal colonization.
- Understanding these age- and sex-related flora changes is key for predicting and preventing pediatric UTIs.
Abstract:
The present study was undertaken to provide information about the presence of bacterial flora in the periurethral region of healthy children and its variation with age and sex. It was intended as a basis for subsequent studies in individuals prone to urinary tract infection. Quantitative methods were used for bacteria sampling and culture. The study included 394 girls and 305 boys from birth to 16 years. During the first few weeks of life a massive aerobic bacterial flora (E. coli, enterococci, staphylococci) was established in the periurethral region of both sexes. The colonization with E. coli and enterococci began to diminish already during the first year of life and became very scanty after the age of 5 years. In newborns E. coli colonization was dense in boys and scanty in girls. Later E. coli was the dominating gram-negative species in girls of all age groups. In boys E. coli dominated during the first half year of life, later Proteus was as common as E. coli; staphylococci did not change very much. Urine samples from healthy school-children contained very few gram-negative bacteria; even when collected without preceding cleansing. The results suggest that there might be a local defence mechanism maturing during the first year of life, eventually protecting the exposed area from colonization with gram-negatives and enterococci.