Risk factors for febrile urinary tract infection in children with myelodysplasia treated by clean intermittent catheterization

Seki, Nobuhiko; Masuda, Katsuaki; Kinukawa, Naoko; Senoh, Kouhei; Naito, Seiji

doi:10.1111/j.1442-2042.2004.00943.x

Cited by 42 publications

(21 citation statements)

References 17 publications

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“…The authors conclude that renal scars in MMC populations are associated with febrile, rUTIs, high-grade VUR, presence of bladder wall trabeculation, and older patient age. Seki et al [ 19 ], agreeably with the current results, also noted that the presence of VUR was directly correlated with febrile UTI, while febrile UTI was a risk factor for renal scarring in MMC children. Furthermore, bladder wall trabeculation was also recognized in the literature as an independent risk factor for renal parenchymal damage and scarring [ 10 ].…”

Section: Discussionsupporting

confidence: 92%

Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?

Miklaszewska

Korohoda

Zachwieja

et al. 2016

IJERPH

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Myelomeningocele (MMC) results from a failure of normal neural tube fusion in early fetal development. Retrospective, observational study of medical data of 54 children treated in Pediatric Nephrology and Urology Clinics for five years was performed. The following data were analyzed: serum creatinine, eGFR, urine analysis, renal scintigraphy (RS), renal ultrasound, and urodynamics. Mean age of studied population: 12.3 years, median of eGFR at the beginning and at the end of survey was 110.25 and 116.5 mL/min/1.73 m2 accordingly. Median of frequency of urinary tract infections (fUTI): 1.2 episodes/year. In 24 children: low-pressure, in 30 children: high-pressure bladder was noted. Vesicouretral reflux (VUR) was noted in 23 children (42.6%). fUTI were more common in high-grade VUR group. High-grade VURs were more common in group of patients with severe renal damage. At the end of the survey 11.1% children were qualified to higher stages of chronic kidney disease. Renal parenchyma damage progression in RS was noted in 22.2% children. Positive VUR history, febrile recurrent UTIs, bladder wall trabeculation, and older age of the patients constitute risk factors of abnormal renal scans. More than 2.0 febrile, symptomatic UTIs annually increase by 5.6-fold the risk of severe renal parenchyma damage after five years.

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Section: Discussionsupporting

confidence: 92%

Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?

Miklaszewska

Korohoda

Zachwieja

et al. 2016

IJERPH

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“…In a study by Seki et al, girls with myelodysplasia were more likely to get colonized with bacteria [19]. Age did not influence the risk for SBU in our population, in accordance with previous studies [20].…”

Section: Discussionsupporting

confidence: 91%

Home screening for bacteriuria in children with spina bifida and clean intermittent catheterization

et al. 2012

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BackgroundSignificant bacteriuria (SBU) and urinary tract infections (UTIs) are common in patients with spina bifida and neuropathic detrusor sphincter dysfunction. Laboratory agar plated culture is the gold standard to establish SBU. It has the disadvantage of diagnostic and subsequent therapeutic delay. Leukocyte esterase tests (LETs) and dip slides proved to be useful in the general populations to exclude SBU and UTI. The aim of this study was to evaluate the reliability of LET and dip slide in children with spina bifida without symptoms of UTI. The reliability in children with asymptomatic SBU was not studied before.MethodsIn one hundred and twelve children with spina bifida on clean intermittent catheterization LETs and dip slides were compared with laboratory cultures. Both tests and agar plated cultures were performed on catheterized urine samples. The hypothesis was that the home tests are as accurate as laboratory cultures.ResultsA SBU was found in 45 (40%) of the 112 laboratory cultures. A negative LET excluded SBU (negative predictive value 96%), while a positive LET had a positive predictive value of 72%. The false positive rate was 28%. Dip slide determination of bacterial growth had no added value, other than serving as transport medium.ConclusionsIn spina bifida children, leukocyte esterase testing can be used to exclude significant bacteriuria at home, while dip slide tests have no added value to diagnose or exclude significant bacteriuria.

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“…There is strong laboratory evidence that increased bladder pressures are associated with bacterial translocation across the urothelium ( 65 ). Furthermore, there is evidence in people with NB that increased bladder pressures are associated with more frequent and more severe UTIs ( 66 ). Therefore, the lack of literature assessing the relationship between oral anticholinergics and UTI is surprising, we hypothesize that the pervasiveness of anticholinergics in NB patients has prevented rigorous analysis of any association that may exist.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

Tradewell

Pariser

Nimeh

et al. 2018

Transl. Androl. Urol.

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Urinary tract infection (UTI) is a source of morbidity and healthcare costs in adults with spina bifida (ASB). UTI prevention strategies are often recommended, but the evidence of various approaches remains unclear. We performed a systematic review to inform a best practice policy statement for UTI prevention in ASB. On behalf of the Neurogenic Bladder Research Group (NBRG.org), we developed an a priori protocol and searched the published English literature for 30 outcomes questions addressing UTI prevention in ASB. The questions spanned the categories of antibiotics, oral supplements, bladder management factors and social support. Where there was little literature in ASB, we included literature from similar populations with neurogenic bladder (NB). Data was abstracted and then reviewed with recommendations made by consensus of all authors. Level of Evidence (LoE) and Grade of Recommendation (GoR) were according to the Oxford grading system. Of 6,433 articles identified by our search, we included 99 publications. There was sufficient evidence to support use of the following: saline bladder irrigation (LoE 1, GoR B), gentamicin bladder instillation (LoE 3, GoR C), single-use intermittent catheterization (IC) (LoE 2, GoR B), hydrophilic catheters for IC (LoE 2, GoR C), intradetrusor onabotulinumtoxinA injection (LoE 3, GoR C), hyaluronic acid (HA) instillation (LoE 1, GoR B), and care coordination (LoE 3, GoR C). There was sufficient evidence to recommend against use of the following: sterile IC (LoE 1, GoR B), oral antibiotic prophylaxis (LoE 2, GoR B), treatment of asymptomatic bacteriuria (LoE 2, GoR B), cranberry (LoE 2, GoR B), methenamine salts (LoE 1, GoR B), and ascorbic acid (LoE1, GoR B). There was insufficient evidence to make a recommendation for other outcomes. Overall, there are few studies in UTI prevention in the specific population of ASB. Research in populations similar to ASB helps to guide recommendations for UTI prevention in the challenging patient group of ASB. Future studies in UTI prevention specific to ASB are needed and should focus on areas shown to be of benefit in similar populations.

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Risk factors for febrile urinary tract infection in children with myelodysplasia treated by clean intermittent catheterization

Cited by 42 publications

References 17 publications

Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?

Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?

Home screening for bacteriuria in children with spina bifida and clean intermittent catheterization

Systematic review and practice policy statements on urinary tract infection prevention in adults with spina bifida

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