ESPN 51th Annual Meeting

ESPN 2018


 
ANTIBIOTIC RESISTANCE AND RISK FACTORS IN PATIENTS WITH NEUROGENIC BLADDER TREATED WITH CLEAN INTERMITTENT CATHETERIZATION
─░LKNUR GIRISGEN 1 SELCUK YUKSEL 1 EFTAL EGEMEN AKBULUT 2 KADRIYE KARCILI 2

1- PAMUKKALE UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- Pamukkale University Faculty of Medicine Department of Pediatrics
 
Introduction:

 We aimed to compare the frequency of isolated bacteria associated with urinary tract infection (UTI) and antibiotic resistance characteristics in children with neurogenic bladder managed with intermittent catheterization versus the children with recurrent urinary tract infections without neurogenic bladder

Material and methods:

 Two groups were designed for study. Group 1 was composed 99 cultures of 26 children with neurogenic bladder (mean age 6.0±4.0 years, 18 girls) and group 2 was composed of 352 cultures of 75 children with recurrent urinary tract infections (mean age 7.2±4.3years, 56 girls). The groups were also divided 2 different subgroups such as with or without vesico-ureteral reflux (VUR + or -) and with or without antibiotic prophylaxis (PPX + or -).

Results:

 The frequencies of isolates were similar in both group 1 and 2, Escherichia coli was the most common agent (64% vs 61%) followed by Klebsiella pneumonia  (18% vs 17%) and Pseudomonas  aeruginosa (9% vs 7%). The frequency of ESBL positive isolates was significantly higher in neurogenic bladder group (34% vs 23%, p=0.03).

A significantly increased resistance against ampicillin was found in the neurogenic bladder (78%) group compared to the nonneurogenic bladder (67%) group (p=0.05). 61% of the patients were using prophylactic antibiotic including mainly co-trimoxazole in neurogenic bladder group. A significantly increased ampicillin and ceftriaxone resistance was also found in the patients with prophylactic antibiotic compared to the patients without prophylactic antibiotic in neurogenic bladder group ( 89% vs 62% p:0.002  and 45.5% vs 24.2%  p:0.047 respectively).

Conclusions:

 Our results show that routine antibiotic prophylaxis usage is not protective against the development urinary tract infection in neurogenic bladder. Furthermore, the growth of resistant microorganisms increased in the antibiotic prophylaxis group.