Journal of Microbiology, Immunology and Infection (Apr 2021)

Association between urine pH and common uropathogens in children with urinary tract infections

  • Huan-Cheng Lai,
  • Shih-Ni Chang,
  • Hsiao-Chuan Lin,
  • Yu-Lung Hsu,
  • Hsiu-Mei Wei,
  • Chin-Chi Kuo,
  • Kao-Pin Hwang,
  • Hsiu-Yin Chiang

Journal volume & issue
Vol. 54, no. 2
pp. 290 – 298

Abstract

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Background/Purpose: Urinary tract infections (UTIs) are one of the most common pediatric infections. Our objective in this study is to investigate the association between urine pH and uropathogens in pediatric patients. Methods: The source population comprised 26 066 paired urinalysis (UA) and urine culture (UC) samples obtained from pediatric patients. We classified the paired UA–UC samples into UTI positive (N = 6348) and UTI negative (N = 19 718) according to the colony forming units corresponding to the sampling source. We included UTI positive patients with infection caused by a single species of pathogen (N = 5201) and frequency matched them with UTI negative patients (N = 4729) by age, sex, sampling source, and visit type. Results: This study included 5201 pediatric patients with UTIs and found that urine with Proteus mirabilis or Pseudomonas aeruginosa demonstrated the least acidic pH (mean pH = 6.72 and 6.62, respectively), whereas urine with Escherichia coli or Klebsiella pneumoniae exhibited the most acidic pH (pH = 6.21 and 6.18). After stratifying the UTI samples by their pH range (<6, 6–6.9, 7–7.9, and ≥8). The prevalence of P. mirabilis increased significantly across increasing pH categories. Conclusion: This research is the first epidemiological study that linked urine pH to specific uropathogens in a pediatric population. Both urine pH and age are associated with certain causative uropathogens. Urine that grew P. mirabilis or P. aeruginosa had the least acidic pH. Additional studies should validate the role of urine pH in predicting uropathogens and UTI.

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