The effect of asymptomatic bacteriuria treatment on antibiotic resistance and development of symptomatic bacteriuria in children with urinary system anomalies

ABSTRACT Nurullayev E. The Effect of Asymptomatic Bacteriuria Treatment on Antibiotic Resistance and Development of Symptomatic Bacteriuria in Children with Urinary System Anomalies. Hacettepe University Faculty of Medicine Pediatric Surgery Specialization Thesis, Ankara, 2020. Asymptomatic bacteriuria (ABU) is a common finding leading inappropriate antibiotic treatment in children with urinary system anomalies. In this study, we aimed to investigate the effects of antibiotic treatment in children with ABU who had urinary system anomalies. The medical records of children who were diagnosed with ABU and had urinary system anomalies in our center in 2016 were analyzed retrospectively. There were 92 ABUs in 32 males (82.1%) and 7 females (17.9%) with a median age of 71 months (28 months-114 months). Urinary system anomalies were; neurogenic bladder (n = 14), hypospadias (n = 12), vesicoureteral reflux (n = 11), ureteropelvic obstruction (n = 5), bladder exstrophy (n = 3), anorectal malformation (n = 3), urogenital sinus anomaly (n = 2) and posterior urethral valve (n = 1). Cultures were obtained from urinary catheter (n=69) and midstream urine (n=23). The most common isolated microorganisms were Escherichia coli, Enterococcus fecalis and Klebsiella pneumonia. Antibiotic treatment was given for 61 ABUs and 39 new bacteriuria two of which were sypmtomatic were detected in control cultures. New bacterial species were detected in 21 of these cultures and new antibiotic resistance was detected in 16. Antibiotic treatment was not given for 31 ABUs and 23 ABU were detected in control cultures. There was no new bacterial species or new antibiotic resistance detected in these cultures. ABU treatment with antibiotics in children with urinary system anomalies causes the development of antibiotic resistance and ABU in which new bacterial species are included. It is important to raise awareness about the rational use of antibiotics in order to prevent these complications. Keywords: urinary system anomaly, asymptomatic bacteriuria, antibiotic resistance