Urinary Tract Infection in Children with Neurogenic Bladder Dysfunction
Introduction. Among all the diseases of the urinary system, microbial-inflammatory lesions dominate, their prevalence is 29 per 1,000 of child population. Neurogenic bladder dysfunction leads to the chronicity and recurrence of urinary tract infections. Objective. To study the etiologic spectrum in children with urinary tract infection associated with neurogenic bladder dysfunction. Materials and methods. The study involved 434 children aged 4 to 15 years, who were hospitalized and out-patient treatment in Omsk from 2008 to 2014. Bacteriological urine culture on the microflora with determining the sensitivity to antibiotics was performed using Urin System Plus (Liofilchem, Italy). At the same time, the urine was examined for the presence of Cytomegalovirus, Herpes simplex virus I–II, Mycoplasma genitalium, Chlamydiae trachomatis, Ureaplasma urealyticum by polymerase chain reaction and enzyme immunoassay. Data processing was performed using Statistica 10.0 software package. Results. It was found that in the urine microbial landscape of children with urinary tract infection and neurogenic bladder dysfunction, Staphylococcus family dominated, unlike the spectrum of uropathogens in patirnts with urinary tract infection without functional obstruction, which is characterized by the predominance of Escherichia coli. The detection rate of cytomegalovirus in the urine indicates a significant decrease in the immunity of children with urinary tract infection and neurogenic bladder dysfunction. Conclusion. The shown differences in microbial landscape of the urine in urinary tract infection associated with neurogenic bladder dysfunction and without functional obstruction must be considered in the selection of an adequate therapy for patients of different groups, including immunocorrective approaches.
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