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Pediatr Nephrol (2009) 24:135139 DOI 10.1007/s00467-008-0974-z
ORIGINAL ARTICLE
Lactobacillus colonization status in infants with urinary tract infection
Jung Won Lee & Yoon Hee Shim & Seung Joo Lee
Received: 9 March 2008 /Revised: 29 July 2008 /Accepted: 30 July 2008 / Published online: 10 September 2008 # IPNA 2008
Abstract To explore the potential protective role of urogenital lactobacilli against urinary tract infection (UTI), lactobacillus cultures were performed on stool and urine specimens and periurethral/vaginal swabs of febrile infants who were suspected of having UTI. Those infants diagnosed with UTI based on the results of the suprapubic urine cultures were allocated to the UTI group (n=60), and those who had a simple viral illness with negative urine cultures were allocated to the control group (n=31). Lactobacilli were anaerobically cultured in lactobacillus-specific DifcoTM Rogosa SL agar for 48 h at 37C and then counted. The lactobacillus colony counts for the stool and urine specimens and periurethral swabs from the UTI group were significantly lower than those for the control group (P<0.05). The geometric means of stool, periurethra, and urine lactobacilli in the UTI group were significantly lower than those in the control group (P<0.05). The colony count of the vaginal lactobacillus demonstrated an equivocal difference between the UTI and control group. In conclusion, this is the first prospective casecontrol study to demonstrate reduced lactobacillus urogenital colonization in infants with UTI. Our results support the view that less urogenital lactobacillus colonization may be a risk factor for UTI in infants even though there is an unclear
possibility that the UTI itself could be the cause of the lower lactobacillus colonies.
Keywords Infants . Lactobacilli . Urinary tract infection
Introduction
Urinary tract infection (UTI) is known as an ascending type of infection by fecal uropathogens, as documented by a genomic profile study [1]. The imbalance between uropathogens and normal flora has been suggested to be a risk factor for UTI [2].
A 1915 study reported that cystitis could be successfully treated by intravesical injection of a lactobacillus strain [3], but this finding was ignored during the following era of widespread antibiotic use. Subsequent evidence on the role of lactobacilli against urogenital infection came from a 1973 study which showed significantly depleted vaginal lactobacilli in women with recurrent urethritis...