Intestinal microbiota in children undergoing surgery for vesicoureteral reflux

Abstract

BACKGROUND: Vesicoureteral reflux (VUR) is one of the most common congenital anomalies of the urinary system in children. In most cases, urinary tract infection (UTI) serves as a clinical prerequisite for identifying VUR. However, a standardized approach to the diagnosis and management of this patient cohort has not yet been established.

AIM: To study the intestinal microbiota in children with VUR who received antibiotic therapy and antibiotic prophylaxis due to episodes of UTIs.

MATERIALS AND METHODS: The study included 40 children (12 boys and 28 girls) with VUR and chronic UTIs. All children received antibiotic therapy for acute episodes of infection, and, after the diagnosis of VUR, they also received continuous antibiotic prophylaxis. The control groups included 18 healthy boys and 14 healthy girls. Identification of microorganisms isolated from feces was carried out using generally accepted methods.

RESULTS: In the feces of children with VUR, aerobic taxa of microbiota dominate over anaerobic ones. Klebsiella spp., Proteus vulgaris, and Pseudomona aeruginosa appear in the feces of both boys and girls. An increase in the detection rate of most aerobic microorganisms and a decrease in anaerobic taxa were observed compared to healthy controls. In boys with VUR, the maximum (100%) detection rate of microorganisms is more common than in girls.

CONCLUSIONS: Dysbiotic changes were detected in the feces of all children after antibiotic therapy, providing new insights into the effects of the conventional strategy of long-term antibacterial treatment and prevention of UTIs in children with VUR.

Keywords

vesicoureteral reflux / microbiota / microbial diversity / intestine / children

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