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2000
Volume 19, Issue 1
  • ISSN: 2772-4328
  • E-ISSN: 2772-4336

Abstract

Urinary tract infections (UTIs) are the most prevalent bacterial infections that occur in children worldwide.

This meta-analysis aims to investigate the utility of probiotics as preventive therapy in children with a UTI.

The Web of Science, PubMed, and Scopus were searched for articles that investigated the relationship between probiotic consumption and the risk of UTIs. The quality of the articles was evaluated using the Jadad scale. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. The Cochran Q test and the statistic I2 were used to evaluate heterogeneity. To determine any potential publication bias, the Egger’s and Begg’s tests were used.

In total, eleven studies were selected for the systematic review and meta-analysis. Compared to children who did not receive probiotics, the OR of developing or having a recurring urinary tract infection in those who received probiotics was 0.94 (95% CI; 0.88–0.999; -value=0.046). The Begg's and Egger's tests showed no evidence of publication bias between probiotics and the risk of developing new or recurring urinary tract infections.

Based on this systematic review and meta-analysis, probiotics could be an alternative therapy for children who are at risk of developing a UTI. They are non-pharmaceutical options and could be used as natural prophylaxis for UTIs. However, the currently published evidence does not irrefutably confirm that probiotics provide a protective effect against urinary bacterial infections. Therefore, there need to be large-scale randomized clinical trials undertaken to investigate the possible prophylaxis of probiotics.

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References

  1. KaufmanJ. Temple-SmithM. SanciL. Urinary tract infections in children: An overview of diagnosis and management.BMJ Paediatr. Open201931e000487e00048710.1136/bmjpo‑2019‑00048731646191
    [Google Scholar]
  2. LeungA.K.C. WongA.H.C. LeungA.A.M. HonK.L. Urinary tract infection in children.Recent Pat. Inflamm. Allergy Drug Discov.201913121810.2174/1872213X1366618122815494030592257
    [Google Scholar]
  3. ArshadM. SeedP.C. Urinary tract infections in the infant.Clin. Perinatol.20154211728vii.10.1016/j.clp.2014.10.00325677994
    [Google Scholar]
  4. BoonH.A. Van den BruelA. StruyfT. GillemotA. BullensD. VerbakelJ.Y. Clinical features for the diagnosis of pediatric urinary tract infections: Systematic review and meta-analysis.Ann. Fam. Med.202119543744610.1370/afm.268434546950
    [Google Scholar]
  5. SabihA. LeslieS.W. Complicated Urinary Tract Infections.Treasure Island, FLStatPearls Publishing2021
    [Google Scholar]
  6. CampbellA. HartlingL. Louie-PoonS. ScottS.D. Exploring the experiences and information needs of parents caring for a child with a urinary tract infection: A qualitative study.J. Patient Exp.20218237437352110082992374373521100829910.1177/2374373521100829934179429
    [Google Scholar]
  7. MedinaM. Castillo-PinoE. An introduction to the epidemiology and burden of urinary tract infections.Ther. Adv. Urol.2019111756287219832172175628721983217210.1177/175628721983217231105774
    [Google Scholar]
  8. SoodA. PennaF.J. EleswarapuS. PucherilD. WeaverJ. Abd-El-BarrA.E. WagnerJ.C. LakshmananY. MenonM. TrinhQ.D. SammonJ.D. ElderJ.S. Incidence, admission rates, and economic burden of pediatric emergency department visits for urinary tract infection: Data from the nationwide emergency department sample, 2006 to 2011.J. Pediatr. Urol.2015115246.e1246.e810.1016/j.jpurol.2014.10.00526005017
    [Google Scholar]
  9. SestitoS. D’AuriaE. BaldassarreM.E. SalvatoreS. TallaricoV. StefanelliE. TarsitanoF. ConcolinoD. PensabeneL. The role of prebiotics and probiotics in prevention of allergic diseases in infants.Front Pediatr.2020858394658394610.3389/fped.2020.58394633415087
    [Google Scholar]
  10. SantosS.C.D. KonstantynerT. CoccoR.R. Effects of probiotics in the treatment of food hypersensitivity in children: A systematic review.Allergol. Immunopathol.20204819510410.1016/j.aller.2019.04.00931477401
    [Google Scholar]
  11. MiqdadyM. Al MistarihiJ. AzazA. RawatD. Prebiotics in the infant microbiome: The past, present, and future.Pediatr. Gastroenterol. Hepatol. Nutr.202023111410.5223/pghn.2020.23.1.131988871
    [Google Scholar]
  12. ShiL.H. BalakrishnanK. ThiagarajahK. Mohd IsmailN.I. YinO.S. Beneficial properties of probiotics.Trop. Life Sci. Res.2016272739010.21315/tlsr2016.27.2.627688852
    [Google Scholar]
  13. XiaoL. DingG. DingY. DengC. ZeX. ChenL. ZhangY. SongL. YanH. LiuF. BenX. Effect of probiotics on digestibility and immunity in infants: A study protocol for a randomized controlled trial.Medicine20179614e5953e595310.1097/MD.000000000000595328383398
    [Google Scholar]
  14. YanF. PolkD.B. Probiotics and immune health.Curr. Opin. Gastroenterol.201127649650110.1097/MOG.0b013e32834baa4d21897224
    [Google Scholar]
  15. AzadM.A.K. SarkerM. WanD. Immunomodulatory effects of probiotics on cytokine profiles.BioMed Res. Int.201820188063647806364710.1155/2018/806364730426014
    [Google Scholar]
  16. HardyH. HarrisJ. LyonE. BealJ. FoeyA.D. Probiotics, prebiotics and immunomodulation of gut mucosal defences: Homeostasis and immunopathology.Nutrients2013561869191210.3390/nu506186923760057
    [Google Scholar]
  17. O’FlahertyS. SaulnierD.M. PotB. VersalovicJ. How can probiotics and prebiotics impact mucosal immunity?Gut Microbes20101529330010.4161/gmic.1.5.1292421327037
    [Google Scholar]
  18. AkgülT. KarakanT. The role of probiotics in women with recurrent urinary tract infections.Turk. J. Urol.201844537738310.5152/tud.2018.4874230487041
    [Google Scholar]
  19. YanT. GoldmanR.D. Probiotics for antibiotic-associated diarrhea in children.Can. Fam. Physician20206613739
    [Google Scholar]
  20. LeekhaS. TerrellC.L. EdsonR.S. General principles of antimicrobial therapy.Mayo Clin. Proc.201186215616710.4065/mcp.2010.063921282489
    [Google Scholar]
  21. AbdullatifV.A. SurR.L. EshaghianE. GauraK.A. GoldmanB. PanchatsharamP.K. WilliamsN.J. AbbottJ.E. Efficacy of probiotics as prophylaxis for urinary tract infections in premenopausal women: A systematic review and meta-analysis.Cureus20211310e18843e1884310.7759/cureus.1884334671514
    [Google Scholar]
  22. DivyaswathiC.S. Gourishankar, A Lactobacillus causing urinary tract infection in a neonate.J. Med. Cases2013410682685
    [Google Scholar]
  23. PageM.J. McKenzieJ.E. BossuytP.M. BoutronI. HoffmannT.C. MulrowC.D. ShamseerL. TetzlaffJ.M. AklE.A. BrennanS.E. ChouR. GlanvilleJ. GrimshawJ.M. HróbjartssonA. LaluM.M. LiT. LoderE.W. Mayo-WilsonE. McDonaldS. McGuinnessL.A. StewartL.A. ThomasJ. TriccoA.C. WelchV.A. WhitingP. MoherD. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews.Rev. Esp. Cardiol. (Engl. Ed.)202174979079910.1016/j.rec.2021.07.01034446261
    [Google Scholar]
  24. HardinA.P. HackellJ.M. SimonG.R. BoudreauA.D.A. BakerC.N. BardenG.A.III MeadeK.E. MooreS.B. RichersonJ. Age limit of pediatrics.Pediatrics20171403e2017215110.1542/peds.2017‑215128827380
    [Google Scholar]
  25. KjaergardL.L. VillumsenJ. GluudC. Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses.Ann. Intern. Med.20011351198298910.7326/0003‑4819‑135‑11‑200112040‑0001011730399
    [Google Scholar]
  26. JadadA.R. MooreR.A. CarrollD. JenkinsonC. ReynoldsD.J. GavaghanD.J. McQuayH.J. Assessing the quality of reports of randomized clinical trials: Is blinding necessary?Control. Clin. Trials199617111210.1016/0197‑2456(95)00134‑48721797
    [Google Scholar]
  27. DaniC. BiadaioliR. BertiniG. MartelliE. RubaltelliF.F. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study.Biol. Neonate200282210310810.1159/00006309612169832
    [Google Scholar]
  28. GhassemiK. MontazeriS. MoghateliM.S. ShakibazadN. FariborziM. Use of probiotics for prophylaxis of urinary tract infection recurrence in children; a randomized controlled trial.Ann. Rom. Soc. Cell Biol.20212076720772
    [Google Scholar]
  29. HoneycuttT.C. El KhashabM. WardropR.M.III McNeal-TriceK. HoneycuttA.L. ChristyC.G. MistryK. HarrisB.D. MelionesJ.N. KocisK.C. Probiotic administration and the incidence of nosocomial infection in pediatric intensive care: A randomized placebo-controlled trial.Pediatr. Crit. Care Med.20078545245810.1097/01.PCC.0000282176.41134.E617693918
    [Google Scholar]
  30. KumarS. BansalA. ChakrabartiA. SinghiS. Evaluation of efficacy of probiotics in prevention of candida colonization in a PICU-a randomized controlled trial.Crit. Care Med.201341256557210.1097/CCM.0b013e31826a409c23361033
    [Google Scholar]
  31. KumarS. SinghiS. ChakrabartiA. BansalA. JayashreeM. Probiotic use and prevalence of candidemia and candiduria in a PICU.Pediatr. Crit. Care Med.2013149e409e41510.1097/PCC.0b013e31829f5d8823965638
    [Google Scholar]
  32. LeeS.J. ChaJ. LeeJ.W. Probiotics prophylaxis in pyelonephritis infants with normal urinary tracts.World J. Clin. Pediatr.201612442542910.1007/s12519‑016‑0013‑227059742
    [Google Scholar]
  33. LeeS.J. LeeJ.W. Probiotics prophylaxis in infants with primary vesicoureteral reflux.Pediatr. Nephrol.201530460961310.1007/s00467‑014‑2988‑z25354903
    [Google Scholar]
  34. LeeS.J. ShimY.H. ChoS.J. LeeJ.W. Probiotics prophylaxis in children with persistent primary vesicoureteral reflux.Pediatr. Nephrol.20072291315132010.1007/s00467‑007‑0507‑117530295
    [Google Scholar]
  35. MohseniM.J. AryanZ. Emamzadeh-FardS. PaydaryK. MofidV. JoudakiH. KajbafzadehA.M. Combination of probiotics and antibiotics in the prevention of recurrent urinary tract infection in children.Iran. J. Pediatr.201323443043824427497
    [Google Scholar]
  36. RojasM.A. LozanoJ.M. RojasM.X. RodriguezV.A. RondonM.A. BastidasJ.A. PerezL.A. RojasC. OvalleO. Garcia-HarkerJ.E. TamayoM.E. RuizG.C. BallesterosA. ArchilaM.M. ArevaloM. Prophylactic probiotics to prevent death and nosocomial infection in preterm infants.Pediatrics20121305e1113e112010.1542/peds.2011‑358423071204
    [Google Scholar]
  37. Sadeghi-BojdS. NaghshizadianR. MazaheriM. Ghane SharbafF. AssadiF. Efficacy of probiotic prophylaxis after the first febrile urinary tract infection in children with normal urinary tracts.J. Pediatric Infect. Dis. Soc.20209330531010.1093/jpids/piz02531100124
    [Google Scholar]
  38. CetinN. YildizB. DinleyiciE.C. KuralN. The usefulness of'saccharomyces Boulardii'in treatment and prophylaxis of urinary tract infection in children. Eds.Pediatric nephrologySpringer: 233 SPRING ST, New York, NY 10013 USA20142991805
    [Google Scholar]
  39. GroahS.L. RoundsA.K. LjungbergI.H. SpragueB.M. FrostJ.K. TractenbergR.E. Intravesical Lactobacillus rhamnosus GG is safe and well tolerated in adults and children with neurogenic lower urinary tract dysfunction: First-in-human trial.Ther. Adv. Urol.201911175628721987559410.1177/175628721987559431620195
    [Google Scholar]
  40. BeyitlerI. KavukcuS. Probiotics for prophylaxis and treatment of urinary tract infections in children.Iran. J. Pediatr.201727210.5812/ijp.7695
    [Google Scholar]
  41. GrinP.M. KowalewskaP.M. AlhazzanW. Fox-RobichaudA.E. Lactobacillus for preventing recurrent urinary tract infections in women: Meta-analysis.Can. J. Urol.20132016607661423433130
    [Google Scholar]
  42. MeenaJ. ThomasC.C. KumarJ. RautS. HariP. Non-antibiotic interventions for prevention of urinary tract infections in children: A systematic review and meta-analysis of randomized controlled trials.Eur. J. Pediatr.2021180123535354510.1007/s00431‑021‑04091‑234156540
    [Google Scholar]
  43. HosseiniM. YousefifardM. AtaeiN. OraiiA. Mirzay RazazJ. IzadiA. The efficacy of probiotics in prevention of urinary tract infection in children: A systematic review and meta-analysis.J. Pediatr. Urol.201713658159110.1016/j.jpurol.2017.08.01829102297
    [Google Scholar]
  44. SchwengerE.M. TejaniA.M. LoewenP.S. Probiotics for preventing urinary tract infections in adults and children.Cochrane Database Syst. Rev.2015201512CD00877210.1002/14651858.CD008772.pub226695595
    [Google Scholar]
  45. TangJ. Microbiome in the urinary system-a review.AIMS Microbiol.20173214315410.3934/microbiol.2017.2.14331294154
    [Google Scholar]
  46. GajdácsM. UrbánE. Resistance trends and epidemiology of Citrobacter-Enterobacter-Serratia in urinary tract infections of inpatients and outpatients (RECESUTI): A 10-year survey.Medicina (Kaunas)201955628510.3390/medicina5506028531216725
    [Google Scholar]
  47. BrubakerL. WolfeA.J. The new world of the urinary microbiota in women.Am. J. Obstet. Gynecol.2015213564464910.1016/j.ajog.2015.05.03226003055
    [Google Scholar]
  48. LembergerU. QuhalF. BruchbacherA. ShariatS.F. HiessM. The microbiome in urinary tract infections in children - an update.Curr. Opin. Urol.202131214715410.1097/MOU.000000000000085833449574
    [Google Scholar]
  49. Kilis-PstrusinskaK. RogowskiA. BienkowskiP. Bacterial colonization as a possible source of overactive bladder symptoms in pediatric patients: A literature review.J. Clin. Med.2021108164510.3390/jcm1008164533924301
    [Google Scholar]
  50. SchafferJ.N. PearsonM.M. Proteus mirabilis and urinary tract infections.Microbiol. Spectr.2015353.5.1010.1128/microbiolspec.UTI‑0017‑201326542036
    [Google Scholar]
  51. Martín-MuñozM.F. FortuniM. CaminoaM. BelverT. QuirceS. CaballeroT. Anaphylactic reaction to probiotics. Cow’s milk and hen’s egg allergens in probiotic compounds.Pediatr. Allergy Immunol.201223877878410.1111/j.1399‑3038.2012.01338.x22957765
    [Google Scholar]
  52. HojsakI FabianoV PopTL Guidance on the use of probiotics in clinical practice in children with selected clinical conditions and in specific vulnerable groups.Acta paediatrica (Oslo, Norway :1992)20181076)927937
    [Google Scholar]
  53. MarkowiakP. Śliżewska, K. Effects of probiotics, prebiotics, and synbiotics on human health.Nutrients201799102110.3390/nu909102128914794
    [Google Scholar]
  54. AilioaieL.M. LitscherG. Probiotics, photobiomodulation, and disease management: Controversies and challenges.Int. J. Mol. Sci.2021229494210.3390/ijms2209494234066560
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): child; Lactobacillus; meta-analysis; Probiotics; systematic review; urinary tract infections
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