RESUMO
Many blood group antigens, genetically controlled carbohydrate molecules, are found on the surface of uroepithelial cells and may affect bacterial adherence and increase the frequency of urinary tract infection (UTI) in adults. Sixty-two children aged 2 weeks to 17 years (mean, 2.3 years) who were hospitalized with fever in association with UTIs caused by Escherichia coli had complete (n = 50) or partial (n = 12) erythrocyte antigen typing to determine the role of erythrocyte antigens and phenotypes in UTI in children; 62 healthy children undergoing nonurologic elective surgery, matched 1 to 1 for age, sex, and race to the patient group, formed the control group. In univariate tests, patients and control subjects did not differ in ABO, Rh, P, Kell, Duffy, MNSs, and Kidd systems by the McNemar test of symmetry (p > 0.05). The frequency of the Lewis (Le) (a-b-) phenotype was higher (16/50 vs 5/50; p = 0.0076) and the frequency of the Le(a + b +) phenotype was lower (8/50 vs 16/50; p = 0.0455) in the patient population than in the control subjects. A stepwise logistic regression model to predict UTI with the explanatory variables A, B, O, M, N, S, s, Pl, Lea, and Leb showed that only the Lea and Leb antigens entered the model with p < 0.1. The Le(a-b-) phenotype was associated with UTI in this pediatric population. The relative risk of UTI in children with the Le(a-b-) phenotype was 3.2 (95% confidence interval, 1.3 to 7.9). Specific blood group phenotypes in pediatric populations may provide a means to identify children at risk of having UTI.
Assuntos
Bacteriúria/sangue , Infecções por Escherichia coli/sangue , Antígenos do Grupo Sanguíneo de Lewis , Infecções Urinárias/sangue , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Fenótipo , Infecções Urinárias/microbiologiaRESUMO
Se analiza la epidemiologia, diagnostico, manejo y pronostico de la Bacteriuria Asintomatica en las pacientes que asistieron a control prenatal en el Instituto Materno Infantil de Bogota y Clinica Hospital Fray Bartolome de las Casas, desde el 1 de mayo de 1987 hasta el 30 de abril de 1988. La frecuencia de Bacteriuria Asintomatica en la mujer embarazada fue del 3%. El 80% de las pacientes estaban entre los 20 y 35 anos. El 60% eran multiparas; la totalidad de raza blanca y mestiza y el 97% de nivel socioeconomico bajo y medio. El 33% tenian factores de riesgo como anemia, preeclampsia, enfermedad renal cronica y flujo gential. En el 64% se hizo el diagnostico en el primero y segundo trimestre, siendo el E. Coli el genero mas frecuente (73%) y el tratamiento se hizo de acuerdo con el antibiograma, teniendo en cuenta las drogas que se pueden utilizar durante el embarazo, con una persistencia del 4% y una recidiva del 4.1% y ninguna paciente presento pielonefritis. La morbilidad materna fue del 26%. Amenaza del parto pretermino, preeclampsia y RPM. La morbilidad perinatal fue del 23%: pretermino y retardo del crecimiento intrauterino.