Abstract Ref Number = APCP1072
DYSBIOSIS IN PEDIATRIC RECURRENT URINARY TRACT INFECTION
Sudung O Pardede,Kanya Ayu Paramastri,Badriul Hegar
Departement of Child Health Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo General Hospital
Background : Recurrent urinary tract infection (UTI) in children is a well-known risk factor of chronic kidney disease. Periurethra is normally inhibited by nonpathogen flora, such as Bifidobacterium sp. In certain condition, pathogen flora from gastrointestinal tract, such as Eschericia coli, inoculates periurethra which causes UTI. Dysbiosis between pathogenic and nonpathogenic bacteria leads to systemic infections, studies in recurrent UTI have not yet been documented.
Material : A cross-sectional studies was conducted in UTI children from age 6 months to <18 years old diagnosed in Cipto Mangunkusumo Hospital to describe dysbiosis in UTI based on proportion differences between gastrointestinal Escherichia coli and Bifidobacterium sp. Healthy child matched in gender and age were recruited as control group. Faecal samples were obtained from all groups and underwent DNA extractions using real time PCR methods for E.coli and Bifidobacterium sp. proportion was counted.
Results : Recurrent UTI children had significantly higher proportion of E.coli compared to control group (10.97 vs 4.74; p=0.014) while proportion of Bifidobacterium sp. was lower (6.54 vs 9.33; p=0.594). E.coli proportion was higher than Bifidobacterium sp. in recurrent UTI but not statistically significant (10.97 vs 6.54; p=0.819). In healthy subjects, Bifidobacterium sp. proportion was significantly higher than E.coli (4.74 vs 9.33; p=0.021). The total amount of E.coli (996,004 vs 1,099,271; p=0,798) and Bifidobacterium sp. (835.921 vs 1.196.991; p=0,711) were higher in complex compared to simple UTI. Logarithm of E.coli (5.50 (SD 1.45) vs 5.92 (SD 0.71); p=0.333) and Bifidobacterium sp. (5.85 (SD 0.75) vs 6.04 (SD 5.50); p= 0.562) proportion were also higher in complicated compare to simple UTI.
Conclusions : Dysbiosis is occurred in children with recurrent UTI. It is shown by high proportion of E.coli, the pathogenic flora of gastrointestinal tract found in fecal material of children with recurrent UTI compare to Bifidobacterium sp. proportion, the nonpathogenic flora.
Keywords: Bifidobacterium E.coli recurrent urinary tract infection dysbiosis