Archives of Pediatrics (ISSN: 2575-825X)

case report

D-Mannose Reduces the Risk of UTI in Complex Paediatric Urology Patients

Ewan M Brownlee1, Christopher Blore2, Ruth Wragg2, M Patel3, Liam McCarthy2*

1Department of Paediatric Urology, Southampton Children’s Hospital, UK

2Department of Paediatric Urology, Birmingham Children’s Hospital, UK

3Department of Paediatric Microbiology, Birmingham Children’s Hospital, UK

*Corresponding author: Liam McCarthy, Consultant Paediatric Urologist and Transplant Surgeon, Department of Paediatric Urology, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK

Received Date: 13 May, 2020, 2020; Accepted Date: 21 May, 2020; Published Date: 28 May, 2020

Abstract

Introduction: Urinary Tract Infections (UTIs) common in complex paediatriac urology patients, resulting in repeated admission, progressive renal impairment, renal transplant losses. Prophylactic antibiotics associated with colonisation with multi-resistant bacteria, eg. ESBL. D-mannose is a fruit extract, inhibiting bacterial adhesion to the urinary tract. We aimed to identify if D-mannose could reduce risk of recurrent UTI and ESBL colonisation in complex urology patients.

Materials and Methods: Tertiary paediatric urology centre. Identified complex paediatric urology patients changed from antibiotic prophylaxis to D-mannose. Demographics, diagnoses, UTI dates, cultures, pyuria recorded before and after starting D-mannose. Paired data compared: UTI/month pre- and post-starting D-mannose. Wilcoxon and Fisher exact test, P<0.05 taken as significant.

Results: 11 patients, median age 11 years (range 7-17). UTI rate reduced 53% from 0.55(0.44-0.79) to 0.26(0-0.38) UTIs/month, P=0.0029. 6 ESBL isolates in 3 patients pre- vs. 1 persisting ESBL isolate on D-mannose. D-mannose well tolerated: only 1 child developing loose stool.

Conclusion: D-mannose is effective prophylaxis, reducing risk of recurrent UTIs by 53% in complex urology patients. This will reduce need for long-term prophylactic antibiotics and may reduce risk of multi-resistant organism colonisation.

Keywords

Complex paediatric urology; D-Mannose; Prophylaxis; Urinary tract infection


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