| Urinary Tract Infection and Neonatal Circumcision |
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Seung Joo Lee |
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Department of Pediatrics, College of Medicine, Ewah Womans University, Seoul, Korea |
| 영유아 요로감염과 신생아 포경수술과의 관계에 대한 연구 |
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이승주 |
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이화여자대학교 의과대학 소아과학교실 |
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| Abstract |
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An association between urinary tract infection in male infants and uncircumcised status has been suggested recently. Male predominance of UTI in most reports in Korea may be related to this uncircumcised status.
The present study was prospectively performed between Mar. 1989 and May. 1991 to investigate this relationship and the effect of neonatal circumcision on the intraurethral bacterial flora.
1) The frequency of UTI was 2.43% in total inpatient children, 2.41% in males and 2.44% in females. In circumcised males the rate was 1.03% which was significantly lower than 2.59% in uncircumcised males(p<0.01).
2) The high frequency of UTI in early life of uncircumcised males declined progressively with increasing age.
3) Male predominance of UTI with high male to female ratio (3.09) in early life became female predominance by age 3 year.
4) The circumcision rate in children with UTI was 4.9% which was significantly lower than 11.6% of children without UTI (p<0.01).
5) The incidence of urinary tract anomaly in circumcised male was 100% which was significantly higher than 21.6% of uncircumcised male and 29.6% of female.
6) The incidence of intraurethral aerobic colony counts over 103/ml in uncircumcised males was significantly higher than circumcised males in early life and decreased progressively with increasing age.
7) The median number of intraurethral coloy counts in uncircumcised male was also significantly higher than circumcised male who had low colony counts from early life. The difference was not significant by age 2 year.
8) The predominant uropathogen in uncircumcised male was changed from E. coli to G(+) cocci around age 1 year. In female E. coli remain constantly predominant during early childhood.
9) The incidence of UTI was jumped from 0~1.2% of children with colony counts below 105/ml to 53.8% in children with colony counts over 105/ml.
The presence of a prepuce is associated with a great quantity of intraurethral uropathogens. This may be important in the pathogenesis of UTI in uncircumcised male infants and may be associated with male predominance of UTI by age 2~3 years in Korea. |
| Key Words:
UTI, Neonatal circumcision, Intraurethral colony counts |
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