Frequency and correlates of bacteriuria among children with neurogenic bladder

Bacteriuria is a common clinical problem among children with neurogenic bladder due to meningomyelocele or traumatic spinal cord injury. To determine the frequency of bacteriuria among affected children at our institution, we obtained 257 urine specimens from 105 children being seen as outpatients for routine care over a 2-year study period. Specimens were obtained via catheterization. Almost half of these specimens (110/257 or 43%) yielded positive results when tested for urinary pathogens. To assess whether any characteristics of these children were related to the likelihood of bacteriuria, we analyzed further a subgroup of 46 children with normal renal ultrasonography from whom two to five specimens were obtained. There were no statistically significant associations between the likelihood of bacteriuria and the following characteristics: age, gender, socioeconomic status, level of spinal cord lesion, voiding technique, and use of prophylactic antibiotics. Children with neurogenic bladder are at high risk for bacteriuria. The pathogenesis of this bacteriuria, its part in deterioration of the urinary tract, and the possible means of its prevention in this special population all deserve further study.