SCREENING FOR ASYMPTOMATIC BACTERURIA IN CHILDREN WITH OBSTRUCTIVE UROPATHY

Abstract

Background: Obstructive uropathy is an important cause of chronic renal failure in children. Obstruction of the urinary tract blocks adequate urine flow. It causes urine stasis, and predisposes the child to asymptomatic bacteruria (ABU) that needed to be followed up to early detect symptomatic UTI. Objective: Screening of ABU in children who were suffering from obstructive uropathy to avoid unnecessary use of antibiotics, early detection and treatment of children who developed symptomatic urinary tract infection (UTI), and relation between type of obstructive uropathy and body growth. Patients and methods: Cross sectional descriptive study was conducted on 50 children with different types of obstructive uropathy. They were selected according to certain inclusion and exclusion criteria from Pediatric Nephrology and Urology outpatient clinics at Al- Hussein University Hospital. Their ages ranged from 2.2 to 11 years. They were subjected to full medical history, complete clinical examination, and routine investigations including renal function tests, urine analysis, urine culture, and imaging studies (included pelvi-abdominal ultrasonography, magnetic resonance urography, renal scan and voiding cystourethrogram). Results: Obstructive uropathy was more common in males (62%) than females (38%), while ABU was common in females. The growth of our patients was not affected by different types of obstructive uropathy. 68% of patients had no bacterial growth, while 32% had bacterial growth in urine culture. The commonest organism was E coli (56.25%). Glomerular filtration rate (GFR) was not significantly affected by different types of obstructive uropathy. Conclusion: Obstructive uropathy can predispose to colonization of bacteria in urinary tract and development of asymptomatic bacteruria especially in females that needs to be followed up. Follow up is needed to early detect symptomatic UTI.