title: Urinary tract infections in children with myelodysplasia in whom clean intermittent catheterization was administered.
abstract: OBJECTIVE
  In this study, it was aimed to evaluate the frequency of significant bacteriuria and antibiotic resistance characteristics in children with myelodysplasia in whom clean intermittent catheterization was administered.
  
  
  METHODS
  The study group was composed of 71 patients with myelodysplasia who were found to have significant bacteriuria (age: 8.20±4.57 years; 39 girls) and the control groups was composed of 49 children who were diagnosed with community-acquired urinary tract infection (age: 7.94±4.17 years; 29 girls). The patient and control groups were evaluated in terms of the microorganisms grown in urinary cultures and antibiotic resistance characteristics. The study approved by the ethics committe (14/02/2012-19/E).
  
  
  RESULTS
  Growth of Escherichia coli (E. coli) was found with the highest rate in myelodysplasic patients. However, when compared with the control group in terms of microorganism types, an increase in the growth rates of the microorganisms excluding E. coli was observed in the patients with myelodysplasia which was close to the significance limit (p=0.055). When antibiotic resistance properties were examined, a significantly increased resistance against cotrimaxazole was found in the patient group compared to the control group (p=0.001). 84.5% of the patients were using prophylactic antibiotic including mainly co-trimoxazole. A significantly increased co-trimoxazole resistance was also found in the patients who were using prophylactic antibiotic compared to the patients who were not using prophylactic antibiotic (p=0.025). The rate of symptomatic UTI was found to be 21% in the patients with myelodysplasia and a significant increase was found in the complaints of abdominal/side pain and nausea/vomiting as well as fever in these patients compared to the patients with asymptomatic bacteriuria (p=0.029 and p=0.032, respectively).
  
  
  CONCLUSIONS
  Our results show that UTI is still a significant problem in patients with myelodysplasia. In addition, they show that use of prophylactic antibiotic may increase the frequency of development of resistance and co-trimoxazole used for this objective is not a good option..
authors.affiliation: Department of Pediatrics, The Ministry of Health, İstanbul Medeniyet University Göztepe Education and Research Hospital, İstanbul, Turkey.
authors.forename: Zuhal Albayrak
authors.initials: ZA
authors.lastname: Yıldız
authors.affiliation: Unit of Pediatric Nephrology, The Ministry of Health, İstanbul Medeniyet University öztepe Education and Research Hospital, İstanbul, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Candan
authors.affiliation: Department of Pediatrics, The Ministry of Health, İstanbul Medeniyet University Göztepe Education and Research Hospital, İstanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arga
authors.affiliation: Unit of Pediatric Nephrology, The Ministry of Health, İstanbul Medeniyet University öztepe Education and Research Hospital, İstanbul, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Turhan
authors.affiliation: Department of Pediatrics, The Ministry of Health, İstanbul Medeniyet University Göztepe Education and Research Hospital, İstanbul, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: İşgüven
authors.affiliation: Department of Pediatrics, The Ministry of Health, İstanbul Medeniyet University Göztepe Education and Research Hospital, İstanbul, Turkey.
authors.forename: Müferet
authors.initials: M
authors.lastname: Ergüven
keywords: Antibiotic resistance; clean intermittent catheterization; myelodysplasia; urinary tract infection