Abstract

TROCHE, Avelina  and  ARAYA, Soraya. Urinary tract infections in patients with myelomeningocele. Rev. Inst. Med. Trop. [online]. 2016, vol.11, n.1, pp.45-49. ISSN 1996-3696.  https://doi.org/10.18004/imt/201611145-49.

Myelomeningocele is the most common cause of neurogenic bladder in children.

These patients are at increased risk of developing urinary tract infection (UTI) by frequent instrumentations on bladder distention, increased bladder pressures, presence of vesicoureteral reflux and after micturition residue. Asymptomatic bacteriuria frequency varies from 42 to 76%, and the incidence is estimated ITU 2.5 episodes per year. Germs most frequently involved are E. coli and Klebsiella pneumoniae, but Pseudomonas aeruginosa, Serratia, Proteus, Acinetobacter, Enterococcus faecalis and also isolated fungi. It is considered that a patient with neurogenic bladder has ITU, if it meets the following criteria: positive urine culture for a single germ with > 100.000 CFU / ml, associated with pathological urinary sediment and clinical compatible with 2 or more of the following signs or symptoms: fever , chills, abdominal pain, back pain, new or worsening incontinence and hematuria same. The clean intermittent catheter (CIL) is used to decrease bladder pressure and associated with the administration of anticholinergic agents, for treating unstable detrusor contractions, in order to preserve renal function. For treatment of UTI, the use of low spectrum antibiotics for the shortest time possible is advised. treatment of asymptomatic bacteriuria is not recommended.

Keywords : bladder infection urinaria- mielomeningocele.

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