ESPN 50th Annual Meeting

ESPN 2017


 
CATHETER-ASSOCIATED BACTERIURIA IN CHILDREN WITH NEUROGENIC BLADDER DUE TO SPINAL DYSRAPHISM
DMYTRO SHEVCHUK 1

1- ZHYTOMYR REGIONAL CHILDREN’S CLINICAL HOSPITAL, UKRAINE
2- Zhytomyr Ivan Franko State University, UKRAINE
3- Shupyk National Medical Academy of Postgraduate Education, UKRAINE
 
Introduction:

 One of the most efficient methods of preventing renal damage due to neuromuscular dysfunction of bladder in patients with spinal dysraphism is a clean intermittent catheterisation (CIC). However, this treatment causes the emergence of catheter-associated bacteriuria (CAB) and / or urinary tract infection (UTI) that both can be called as a catheter-associated urinary tract infection (Catheter-associated Urinary Tract Infections / CAUTI).

Material and methods:

 All patients who were admitted to Zhytomyr Regional Children’s Clinical Hospital with the neurogenic bladder and whom the CIC was administered, were subjected to the mandatory microbiological examination of urine. In case of therapeutic failure of the conservative treatment and the progressive renal damage, surgical treatment has been employed.

Results:

 The most frequent etiological agents of the CAUTIs were the following microorganisms: Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, Klebsiella pneumonia, Proteus spp. and others. It was found that the percentage of the UTIs caused by P. mirabilis, P. vulgaris and Enterococcus faecalis tripled for the last three years, and the infections caused by E. coli increased by 30 per cent as well in patients with the CIC. In contrast, the growth of Kl. pneumoniae decreased by 2.5 times and the Ps. aeruginosa growth decreased by 30 per cent as the cause of the UTI in the patients who underwent surgical treatment.

Conclusions:

 The adequate choice of urinary diversion in paediatric patients with neuromuscular dysfunction of the bladder due to spinal dysraphism can reduce the bacterial contamination of urine and prevent the irreversible renal damage.