title: Preputial bacterial colonisation in uncircumcised male children: Is it related to phimosis?
abstract: OBJECTIVE
  To evaluate the presence of uropathogens in the periurethral skin and the effect of phimosis on bacterial colonisation.
  
  
  METHODS
  The observational cohort study was conducted in Samsun Research and Training Hospital, Samsun, Turkey from June to December, 2014, and comprised patients undergoing circumcision. Before circumcision, all children were examined in the operating room and the presence of phimosis was recorded. All patients had circumcision performed by the same surgical team under general anaesthesia. Before the procedure, samples were taken from preputial skin of all patients by swab before cleansing with polyvidone-iodine. The samples were inoculated on 5% sheep blood agar and eosin-methylene blue agar.
  
  
  RESULTS
  The median age of the 117 children was 5 years (range: 1-12). Of the total, 19(16.2%) children had complete phimosis, and 72(61.5%) had partial phimosis. In all,91(77.7%) children had phimosis and 26(22.3%) had no phimosis. Of the 91 patients with different degrees of phimosis, 52(57.1%) had clinically significant uropathogenic bacterial colonisation >100,000 colony-forming units per millilitre [cfu/ml]). Of the 26 patients without phimosis, 13(50%) had clinically significant colonisation. Thus, there was no effect of the presence of phimosis on bacteria colonisation (p=0.655).
  
  
  CONCLUSIONS
  Important uropathogens colonise the preputium in uncircumcised male children. There was no effect of phimosis on colonisation.
authors.affiliation: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Lokman
authors.initials: L
authors.lastname: Irkilata
authors.affiliation: Department of Urology, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Hasan Riza
authors.initials: HR
authors.lastname: Aydin
authors.affiliation: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aydin
authors.affiliation: Department of Microbiology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Gorgun
authors.affiliation: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Huseyin Cihan
authors.initials: HC
authors.lastname: Demirel
authors.affiliation: Department of Urology, Ataturk University, Erzurum, Turkey.
authors.forename: Senol
authors.initials: S
authors.lastname: Adanur
authors.affiliation: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Ebubekir
authors.initials: E
authors.lastname: Akgunes
authors.affiliation: Department of Infections Diseases, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Atilla
authors.affiliation: Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
authors.forename: Mustafa Kemal
authors.initials: MK
authors.lastname: Atilla
mesh_terms: D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male; D015331:Cohort Studies; D016983:Enterococcus / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections; D052816:Foreskin / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D010688:Phimosis / Q000453:epidemiology*; D011512:Proteus Infections / Q000453:epidemiology; D011513:Proteus mirabilis / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000453:epidemiology; D013210:Staphylococcus / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014421:Turkey / Q000453:epidemiology
keywords: Circumcision, Male, Child, Phimosis, Bacterial colonisation.