Probiotic lactobacillus as preventive measure for UTIs
Friday, 8 May 2009- Probiotic lactobacillus as preventive measure against urinary tract infections (UTI) was the focus of a study that won the European Society for Paediatric Urology (ESPU)-AAP exchange fellowship award. The findings of lead investigator Dr. Michael Hsieh were presented yesterday at the ESPU's 20th anniversary congress which is on its last full today in Amsterdam, the Netherlands.
According to research, UTI represent a significant source of morbidity for children with spina bifida. In girls, uropathogens originating from the gut migrate through the vagina in order to ascend the urinary tract. The rate of bacteriuria among catheterization-dependent children with spina bifida is at least 40 to 80%, with many patients experiencing multiple episodes of UTI in association with bacteriuria.
Hsieh said that clinical trials have suggested that oral ingestion of probiotic strains, such as L. reuteri RC-14 and L.rhamnosus GR-1, results in normalization of the vaginal microbiota and reduced the risk of UTI in women. However, no studies have been carried out on catheterized girls.
Hsieh and colleagues conducted an open label, pilot clinical trial of orally administered RC-14 and GR-1 (2X10 cfu of each daily) in catheterization-dependent girls with spina bifida.
Nine subjects were recruited for the study, with a mean age of 3.5 years. Two of nine subjects had pre-existing, asymptomatic bacteruria. After three months of taking the probiotics, one subject demonstrated clearance of bacteriuria, whereas the other continued to have bacteriuria. Of the other seven subjects, all developed bacteriuria at least once.
Only one subject had a symptomatic, febrile UTI during a total of 109 patient-weeks of follow-up, which was less than expected based upon previous records of the patients. No adverse effects associated with probiotic use were observed.
The investigators concluded that orally ingested L.reuteri RC-14 and L. rhamnosus GR-1 were well-tolerated by the children. The three-month use of prophylactic probiotic lactobacilli did not appear to reduce acquisition of bacteriura in girls, but may have prevented episodes of symptomatic UTI. Hsieh said they are now planning a randomized clinical trial to further test their hypothesis.
