Risk factors for recurrent urinary tract infection in children with neurogenic bladders treated by clean intermittent catheterization / 中华实用儿科临床杂志

ABSTRACT

Objective To identify the risk factors associated with recurrent urinary tract infection (RUTI) in children with neurogenic bladders (NB) who received clean intermittent catheterization (CIC) in order to provide recommendations for reducing the risk of RUTI.Methods Records of 184 children with NB managed by CIC at the Department of Urology Surgery,the First Affiliated Hospital of Zhengzhou University from July 2011 to September 2015 were reviewed and analyzed.According to UTI incidence,they were divided into 2 groups as occasional UTI group (0-1 time/year,OUTI group) and RUTI group (＞ 1 time/year).The clinical and urodynamic data were compared between 2 groups,and the risk factors were identified by regression analysis.Results Of the total patients,147 patients (79.9％) were diagnosed as OUTI and 37 cases (20.1％) as RUTI.Median follow-up lasted for average 27 months (12-39 months).The characteristics of RUTI group was indicated significantly in the study,which included increasing age(7.4 years old vs.5.9 years old),a higher level of spinal lesions,and more vesicoureteral reflux(VUR),and there were significant differences in bladder wall thickness(4.7 cm vs.3.6 cm) and lower bladder compliance compared with RUTI group (all P ＜ 0.05).But there was no statistical significance in gender,antibiotics,hydronephrosis,incontinence,bladder capacity,detrusor overactivity,detrusor sphincter dyssynergia and detrusor leakage point pressure between 2 groups (all P ＞ 0.05).Increasing age,increased bladder wall thickness,lower bladder com-pliance and the presence of VUR were independent risk factors associated with RUTI group (all P ＜ 0.05).Conclusions Increasing age,increasing bladder wall thickness,lower bladder compliance and VUR are the risk factors for RUTI in NB children managed with CIC.It is necessary to follow up video-urodynamic and ultrasound findings in order to identify the high-risk patients and provide the evidence for preventing RUTI.