title: Novel management of urinary tract infections.
abstract: OBJECTIVE
  To highlight observations that have suggested the need for changing the conventional approach to the evaluation and management of urinary tract infections (UTIs) and vesicoureteral reflux in children and examine new alternative approaches to prevention of UTI and renal scarring based on research into host-pathogen interaction.
  
  
  RESULTS
  Recent studies have questioned the traditional approach of using prophylactic antibiotics to prevent recurrence of UTI and development of renal scarring in children with vesicoureteral reflux. Ongoing research on host-pathogen interactions reveals a promising capability to analyze virulence factors in bacteria causing UTIs in children, identify highly virulent bacteria capable of causing pyelonephritis and renal injury, and to selectively target the gastrointestinal reservoirs of these bacteria for elimination using probiotics.
  
  
  CONCLUSIONS
  Promising experimental studies correlating bacterial virulence with pattern of UTI and identification and characterization of a newly available probiotic capable of eradicating uropathogenic bacteria make targeted probiotic prevention of renal injury-inducing UTIs a potential therapeutic reality.
authors.affiliation: Department of Urology, Naval Medical Center, San Diego, California, USA.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Storm
authors.forename: Ashay S
authors.initials: AS
authors.lastname: Patel
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Koff
authors.forename: Sheryl S
authors.initials: SS
authors.lastname: Justice
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D054884:Host-Pathogen Interactions; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000382:microbiology / Q000517:prevention & control*; D008297:Male; D019936:Probiotics; D012008:Recurrence; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000382:microbiology / Q000517:prevention & control*; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000382:microbiology / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents