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Introduction: Idiopathic hypercalciuria (IH) has been recognized as a common disorder in childhood and is an important and common factor in formation of renal stones. Recurrent urinary tract infection is a clinical presentation of hypercalciuria. Regarding that Hydrochlorothiazide is effective in hypercalciuria treatment, therefore in this study we assessed the efficacy of Hydrochlorothiazide in preventing recurrent UTI in hypercalciuric girl patients. Materials & Methods: This research was a single blind randomized clinical trial. 100, 1 to 12 years old girls, who were followed by pediatric nephrology outpatient clinic in Vali-Asr and Amir Kabir hospitals, with the diagnosis of idiopathic hypercalciuria and at least two urinary tract infections in year, were included in study. Patients were randomly divided into two equal groups. First group received a general preventive treatment consisted of a liberal fluid , urination every 2 hours , reducing dietary salt intake , washing genitalia from front to back , wearing cotton loose underwear and complete urination. In second group, in addition to the general treatment, Hydrochlorothiazide was used with initial dose of 1mg/kg/day in a morning dosage.Then, urinary tract infection recurrence in two groups was assessed by student T test. Results: All patients who received Hydrochlorothiazide were normocalciuric. In each group, incidence of UTI non recurrence was 34% (17 cases), that was not significantly different. Conclusion: This study rejected the presence of hypercalciuria treatment effect in preventing recurrent urinary infection. Therefore, the association between UTI and IH needs to be closely studied with the attention to eliminate confounding factors.

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Introduction: Hydronephrosis in infancy and childhood is a frequent urinary malformation. We were unable to find any reports concerning rate and causes of hydronephrosis in Iranian children therefore, we decided to evaluate it, in under 12 years old children. Materials and Methods: This was a descriptive study done in a 9-month period starting from Novemger 2004. All children under 12 years old who had visited Amir Kabir hospital of Arak for UTI or FTT were enlisted and an ultrasonography was requested. If hydronephrosis was detected, then a VCUG was performed. For those with normal VCUG results, if hydronephrosis persisted in the follow up sonography, the next step was an IVP or DTPA scan. Results: 65 patients (39 girls and 26 boys) were evaluated for hydronephrosis. 18.5% presented with FTT , 75.4% with UTI and 6.1% with FTT+UTI. The most prevalent causes of hydronephrosis were VUR (40%) and UPJO (23.5%). Grade I hydronephrosis was the most prevalent form (65%), however when VUR was present , it was mostly grades III or IV (27% and 19% respectively). 70% of girls and 31% of boys had VUR and the average age at the time of diagnosis was 2-3 years. Conclusion: Vesicouretero reflux and UPJO are the most prevalent causes of hydronephrosis and must be evaluated in children with hydronephrosis.

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Introduction: Children with reflux who fail prophylaxis management or reflux which do not resolve spontaneously are candidates for sugery. Delay in surgery increases the development of new renal scars. Finding a modal factor for prediction of reflux resolution likelihood can decrease complications of treatments. Regarding that sacral bone anomalies have a direct influence on the final function of urinary and bowel systems, this study is done to investigate the relationship between sacral ratio and reflux. Materials and Methods: This is a case-control study. The case group included 76 children less than 9 years old refered to Vali-e-Asr and Amir Kabir hospital clinics with urinary tract infection and according to voiding cystouretrograply (VCUG) results, children with III, IV and V grade vesicoureteral reflux (VUR) entered the study. The control group included 76 children with previous urinary tract infection and normal VCUG. Sacral ratio in the two groups was measured and was compared by student t, Chi square and Mann Whitney tests. Results: The case group included 24 males and 52 females with average age of 2.7 years old and the control group included 23 males and 53 females with the average age of 3 years. The percent of sacral ratio abnormality were 40% and 23.7% in the case and control groups respectively, which was significantly different (p=0.001). The difference between the mean sacral ratio in case group with the value of 80% and the control group with the value of 84% was not different. The ratio distribution pattern in the two groups was not different. Conclusion: The percent of sacral ratio abnormality in children with vesicoureteral reflux were more than children without reflux.

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  Background : Urine tract infection(UTI) among children is the most prevalent bacterial infection and the second prevalent infection after Viral Flu.Regarding this cfact that urine culturing has very important role in diagnisis and perseverance of this disease and sampling method has significant effect on this disease remedy.

  In this study the effect of genital area ablution on decreasing the contamination of urine culture is examined.

  Methods and Materials: This study is in the form of case_controlled.In this study 620 little girls (3-12 years –old) referring to Amir Kabir children special clinic are examined.Population under investigation was cpatients who had not history of taking antibiotic during last seven days, sondage and genital anomaly and inflammation and genital discharge. 

  Patients were randomly entered in two different groups one with ablution and the other without ablution.After data collection, available inputs were statistically analyzed with SPSS and the effect of genital area ablution was determined on decreasing the contamination of urine culture.

  Results: Among 310 patients in with_ablution group 11 patients were reported UTI(3/7%).3 patients were contaminated (1%),296 patients were normal (95/3%).Among 310 patients in the second group,14 patients were reported UTI(4/7%),6 patients were contaminated(2%),290 patients were normal(93/3%).Contamination rate in with_ablution group were 1% and in the other group was 2%Based on Pvalue :0/491 in both groups no significant statistically difference were found between these two groups and the analysis result distribution in both groups in a=0/05 level were statistically the same.

  Conclusion: In both group no significant statistically difference were found between these two groups ,so we concluded that the genital area ablution doesn’t have such an effect on decreasing the contamination of urine culture and we don’t suggest ablution of genital area in children before providing urine sampling.

 

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Abstract

Background: Probiotics are known as a factor for prevention of infectious diseases such as urinary tract infection(UTI). The present study aimed to investigate the positive effects of probiotics on urinery truct infection of cateterized intensive care unit patients.

Materials and Methods: In a triple blind clinical trial, 125 cateterized intensive care unit patients were randomly selected and divided into two groups, Treatment group (n = 63) was well matched with placebo group (n = 62) for age and sex and duration of admission .Case group received one lactocare capsule for 10 days and control group with a same method received placebo for 10 days. In both groups urine analysis and urine culture were measured with a same method at the first day and then twentieth day and finally data were analysed with t-test.

Results: The incidence of urinary tract infection between treatment and control group (respectively 17.4% and 22.5%) had no statistically significant difference (p=0.672). But, in terms of sex, incidence of urinary tract infections in women compared to men with the same condition was significantly different(p=0.002). In treatment group with long term cathetrization, urinary tract infections significantly were significantly different(p=0.041).

Conclusion: Administration of lactocare capsule has no statistically significant impact on the incidence of urinery truct infection of cateterized intensive care unit patients. In comparsion of cateterized men and women receiving probiotics, the reduction of urinary tract infection in women was more than in men. Probiotics had preventive effects on long term catheterization.

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Introduction: Considering the importance of urinary tract infections caused by uropathogenic Escherichia coli (UPEC) in the medical field, this study aimed to investigate serogroups O25 and O16 and the pattern of antibiotic resistance among UPEC isolates obtained from hospitalized patients with urinary tract infections (UTIs) in Rasht hospitals.
Methods: A total of 110 urine samples were collected from patients with UTIs referred to selected hospitals in Rasht. The disk diffusion method, as recommended by the CLSI, was used to determine the pattern of antibiotic susceptibility. Serogroups O25 and O16 were detected using specific primers.
Results: Among the studied samples, 36.4% (40/110) were men and 63.6% (70/110) were women. Based on the antibiotic susceptibility pattern, a high level of antibiotic resistance was observed against nalidixic acid (81.8%) and co-trimoxazole (78.2%), while the most effective antibiotics were amikacin (85.5%) and nitrofurantoin (83.6%). In addition, multi-drug resistant phenotype was found in 72.7% (110/80) of UPEC isolates. According to PCR results, the frequency of serogroups O25 and O16 was 36.4% and 17.3%, respectively. Both serogroups had the highest resistance to nalidixic acid and co-trimoxazole, while the lowest resistance in serogroup O25 to nitrofurantoin (20%) and amikacin (14.3%) and in serogroup O16 to imipenem (5.3%) and nitrofurantoin (10.5%).
Conclusions: This study showed that the high prevalence of MDR strains among UPEC strains is very worrying and professionals should be very careful in prescribing antibiotics for patients. Like most studies, the frequency of serogroup O25 was high, and probably, this serogroup can play a role in causing urinary tract infections and antibiotic resistance of UPEC strains.