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 OJU  Vol.1 No.4 , November 2011
Which Patients Should be Administrated Prophylactic Antibacterial Agents? A Study of Bacteriuria or Funguria by Urine Culture Taken From the Renal Pelvis in Children with Ureteropelvic Junction Obstruction
Abstract: Objective: To detect bacteriuria or funguria by urine culture taken from the renal pelvis directly before Anderson-Hynes pyeloplasty. Methods: 290 patients who underwent Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction (UPJO) were included in a retrospective analysis. Urine was obtained directly before the renal pelvis was opened, and was carried to the laboratory for bacterial culture. Clinical features were analyzed to evaluate risk factors for bacteriuria or funguria by comparing patients whose urine yielded positive cultures to those whose urine cultures were negative for bacteria or yeast. Results: Eighteen patients (6.2%) had positive urine cultures, including six cultures positive for Escherichia coli (E. coli), four for Pseudomonas aeruginosa, three for klebsiella pneumoniae, one for maltophilia monad, one for Enterococcus faecium, one for Candida albicans, one for Candida parapsilosis, and one for yeast not otherwise specified. Bacteriuria or funguria was significantly correlated with four clinical features: fever, urinary urgency, and history of nephrostomy or pyeloplasty. Conclusions: Bacteriuria or funguria was less common in children with UPJO, and the majority of organisms were identified as Escherichia coli, Pseudomonas aeruginosa, or Klebsiella pneumoniae. Prophylactic antibacterial agents were probably necessary in those patients who had signs of urinary tract infection (UTI), or history of nephrostomy or pyeloplasty.
Cite this paper: nullG. Deng, L. Zhang, Z. Li and Y. Wen, "Which Patients Should be Administrated Prophylactic Antibacterial Agents? A Study of Bacteriuria or Funguria by Urine Culture Taken From the Renal Pelvis in Children with Ureteropelvic Junction Obstruction," Open Journal of Urology, Vol. 1 No. 4, 2011, pp. 76-80. doi: 10.4236/oju.2011.14016.
References

[1]   C. C. Roth, J. M. Hubanks, B. C. Bright, et al., “Occurrence of Urinary Tract Infection in Children with Significant Upper Urinary Tract Obstruction,” Urology, Vol. 73, No. 1, 2009, pp. 74-78. doi:10.1016/j.urology.2008.05.021

[2]   S. H. Song, S. B. Lee, Y. S. Park and K. S. Kim, “Is Antibiotic Prophylaxis Necessary in Infants with Obstructive Hydronephrosis?” Journal of Urology, Vol. 177, 2007, pp. 1098-1101.

[3]   A. W. Bauer, W. M. Kirby, J. C. Sherris and M. Turck. “Antibiotic Susceptibility Testing by a Standardized Single Disk Method,” American Journal of Clinical Pathology, Vol. 45, 1996, pp. 493-496.

[4]   C. Delaned, “Antenatal Hydronephrosis: Trends and Management,” Urological Nursing, Vol. 25, No. 3, 2005, pp. 179-183.

[5]   C. Mami, A. Paolata, A. Palmara, et al., “Outcome and Management of Isolated Moderate Renal Pelvis Dilatation Detected at Postnatal Screening,” Pediatric Nephrology, Vol. 24, No. 10, 2009, pp. 2005-2008.

[6]   B. Chertin, A. Pollack, D. Koulikov, et al., “Conservative Treatment of Ureteropelvic Junction Obstruction in Children with Antenatal Diagnosis of Hydronephrosis: Lessens Learned after 16 Years of Follow-up,” European Urology, Vol. 49, 2006, pp. 734-739.

[7]   J. J. Zorc, D. A. Kiddoo and N. Kathy, “Shaw: Diagnosis and Management of Pediatric Urinary Tract Infections,” Clinical Microbiology Reviewa, Vol. 18, No. 2, 2005, pp. 417-422. doi:10.1128/CMR.18.2.417-422.2005

[8]   J. H. Lee, H. S. Choi, J. K. Kim, et al., “Nonrefluxing Neonatal Hydronephrosis and the Risk of Urinary Tract Infection,” Journal of Urology, Vol. 179, No. 4, 2008, pp. 1524-1528.

[9]   A. Hellstrom, E. Hanson, S. Hansson, K. Hjalmas, et al., “Associatin between Urinary Symptoms at 7 Years Old and Previous Urinary Tract Infection,” Archives of Disease in Childhood, Vol. 66, No. 2, 1991, pp. 323-334.

[10]   S. A. Lutter, M. L. Currie, L. B. Mitz, et al., “Antibiotic Resistance Patterns in Children Hospitalized for Urinary Tract Infection,” Archives of Pediatrics & Adolescent Medicine, Vol. 159, 2005, pp. 924-927.

 
 
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