Comparison of types of microorganisms and antibiotic resistance in patients with neurogenic bladder treated with clean intermittent catheterization and children with normal bladder and recurrent urinary tract infection.

Purpose: In this study, it was aimed to compare the frequency of significant bacteriuria and antibiotic resistance characteristics in children with myelodysplasia-neurogenic bladder in whom clean intermittent catheterization (CIC) and children with normal bladder and recurrent urinary tract infection. Material-Methods: Children with neurogenic bladder in whom CIC group were divided into two subgroups as taking antibiotic prophylaxis and not. Children with normal bladder and recurrent urinary tract infection group were divided in to two subgroups as with vesicoureteral reflux and without. Renal scar, vesicoureteral reflux, microorganism types, antibiotic resistance in urine culture antibiogram was compared in all groups. Results: The neurogenic bladder group was composed 99 cultures of 26 patients (mean age:6.01±4.00 years 18 girls) who were found to have significant bacteriuria and the normal bladder group was composed of 352 cultures of 75 children (mean age:7.2±4.34 years 56 girls). Growth of Escherichia coli was found with the highest rate in children with neurogenic bladder and children with normal bladder. However ESBL producing microorganisms were found highest rate in children with neurogenic bladder than children with normal bladder. A significant increase resistance to ampicillin and piperacillin tazobactam was found in children with neurogenic bladder than children with normal bladder. Non E. Coli microorganisms such as Klebsiella were found highest rate in children with neurogenic bladder who were using prophylactic antibiotic. A significant increase resistance to ampicillin, ceftriaxone and gentamicin resistance was also found in the patients who received prophylactic antibiotic compared to the patients who did not receive prophylactic antibiotic in children with neurogenic bladder. A significant increase resistance to ampicillin, gentamicin, trimethoprim-sulfamethoxazole, aztreonam, cefepime, ceftazidime, fosfomycin was also found in the patients with vesicoureteral reflux than without. Conclusion: Early and correct treatment as CIC may easily prevent renal damage in children with myelodysplasia-neurogenic bladder. The use of prophylactic antibiotics may lead to the development of drug-resistance in patients with neurogenic bladder. Therefore use of prophylactic antibiotics this group may not be necessary. Highest antibiotic resistance was found in the patients with normal bladder and vesicoureteral reflux. Also a significant increase renal scar incidence in same group. Although, it was concluded that prophylactic antibiotic use should be