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Current Reviews in Clinical and Experimental Pharmacology

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ISSN (Print): 2772-4328
ISSN (Online): 2772-4336

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Meta-Analysis

Effect of Probiotics on Urinary Tract Infections in Children: A Systematic Review and Meta-Analysis

Author(s): Elham Emami, Catherine MT Sherwin and Saeid Heidari-Soureshjani*

Volume 19, Issue 1, 2024

Published on: 20 August, 2022

Page: [111 - 121] Pages: 11

DOI: 10.2174/2772432817666220501114505

Price: $65

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Abstract

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

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

Methods: 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.

Results: 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; p-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.

Conclusion: 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.

Keywords: Probiotics, urinary tract infections, child, systematic review, meta-analysis, Lactobacillus.

« Previous Next »
[1]
Kaufman, J.; Temple-Smith, M.; Sanci, L. Urinary tract infections in children: An overview of diagnosis and management. BMJ Paediatr. Open, 2019, 3(1), e000487-e000487.
[http://dx.doi.org/10.1136/bmjpo-2019-000487] [PMID: 31646191]
[2]
Leung, A.K.C.; Wong, A.H.C.; Leung, A.A.M.; Hon, K.L. Urinary tract infection in children. Recent Pat. Inflamm. Allergy Drug Discov., 2019, 13(1), 2-18.
[http://dx.doi.org/10.2174/1872213X13666181228154940] [PMID: 30592257]
[3]
Arshad, M.; Seed, P.C. Urinary tract infections in the infant. Clin. Perinatol., 2015, 42(1), 17-28. vii.
[http://dx.doi.org/10.1016/j.clp.2014.10.003] [PMID: 25677994]
[4]
Boon, H.A.; Van den Bruel, A.; Struyf, T.; Gillemot, A.; Bullens, D.; Verbakel, J.Y. Clinical features for the diagnosis of pediatric urinary tract infections: Systematic review and meta-analysis. Ann. Fam. Med., 2021, 19(5), 437-446.
[http://dx.doi.org/10.1370/afm.2684] [PMID: 34546950]
[5]
Sabih, A.; Leslie, S.W. Complicated Urinary Tract Infections; StatPearls Publishing: Treasure Island, FL, 2021.
[6]
Campbell, A.; Hartling, L.; Louie-Poon, S.; Scott, S.D. Exploring the experiences and information needs of parents caring for a child with a urinary tract infection: A qualitative study. J. Patient Exp., 2021, 8, 23743735211008299-23743735211008299.
[http://dx.doi.org/10.1177/23743735211008299] [PMID: 34179429]
[7]
Medina, M.; Castillo-Pino, E. An introduction to the epidemiology and burden of urinary tract infections. Ther. Adv. Urol., 2019, 11, 1756287219832172-1756287219832172.
[http://dx.doi.org/10.1177/1756287219832172] [PMID: 31105774]
[8]
Sood, A.; Penna, F.J.; Eleswarapu, S.; Pucheril, D.; Weaver, J.; Abd-El-Barr, A.E.; Wagner, J.C.; Lakshmanan, Y.; Menon, M.; Trinh, Q.D.; Sammon, J.D.; Elder, J.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., 2015, 11(5), 246.e1-246.e8.
[http://dx.doi.org/10.1016/j.jpurol.2014.10.005] [PMID: 26005017]
[9]
Sestito, S.; D’Auria, E.; Baldassarre, M.E.; Salvatore, S.; Tallarico, V.; Stefanelli, E.; Tarsitano, F.; Concolino, D.; Pensabene, L. The role of prebiotics and probiotics in prevention of allergic diseases in infants. Front Pediatr., 2020, 8, 583946-583946.
[http://dx.doi.org/10.3389/fped.2020.583946] [PMID: 33415087]
[10]
Santos, S.C.D.; Konstantyner, T.; Cocco, R.R. Effects of probiotics in the treatment of food hypersensitivity in children: A systematic review. Allergol. Immunopathol., 2020, 48(1), 95-104.
[http://dx.doi.org/10.1016/j.aller.2019.04.009] [PMID: 31477401]
[11]
Miqdady, M.; Al Mistarihi, J.; Azaz, A.; Rawat, D. Prebiotics in the infant microbiome: The past, present, and future. Pediatr. Gastroenterol. Hepatol. Nutr., 2020, 23(1), 1-14.
[http://dx.doi.org/10.5223/pghn.2020.23.1.1] [PMID: 31988871]
[12]
Shi, L.H.; Balakrishnan, K.; Thiagarajah, K.; Mohd Ismail, N.I.; Yin, O.S. Beneficial properties of probiotics. Trop. Life Sci. Res., 2016, 27(2), 73-90.
[http://dx.doi.org/10.21315/tlsr2016.27.2.6] [PMID: 27688852]
[13]
Xiao, L.; Ding, G.; Ding, Y.; Deng, C.; Ze, X.; Chen, L.; Zhang, Y.; Song, L.; Yan, H.; Liu, F.; Ben, X. Effect of probiotics on digestibility and immunity in infants: A study protocol for a randomized controlled trial. Medicine, 2017, 96(14), e5953-e5953.
[http://dx.doi.org/10.1097/MD.0000000000005953] [PMID: 28383398]
[14]
Yan, F.; Polk, D.B. Probiotics and immune health. Curr. Opin. Gastroenterol., 2011, 27(6), 496-501.
[http://dx.doi.org/10.1097/MOG.0b013e32834baa4d] [PMID: 21897224]
[15]
Azad, M.A.K.; Sarker, M.; Wan, D. Immunomodulatory effects of probiotics on cytokine profiles. BioMed Res. Int., 2018, 2018, 8063647-8063647.
[http://dx.doi.org/10.1155/2018/8063647] [PMID: 30426014]
[16]
Hardy, H.; Harris, J.; Lyon, E.; Beal, J.; Foey, A.D. Probiotics, prebiotics and immunomodulation of gut mucosal defences: Homeostasis and immunopathology. Nutrients, 2013, 5(6), 1869-1912.
[http://dx.doi.org/10.3390/nu5061869] [PMID: 23760057]
[17]
O’Flaherty, S.; Saulnier, D.M.; Pot, B.; Versalovic, J. How can probiotics and prebiotics impact mucosal immunity? Gut Microbes, 2010, 1(5), 293-300.
[http://dx.doi.org/10.4161/gmic.1.5.12924] [PMID: 21327037]
[18]
Akgül, T.; Karakan, T. The role of probiotics in women with recurrent urinary tract infections. Turk. J. Urol., 2018, 44(5), 377-383.
[http://dx.doi.org/10.5152/tud.2018.48742] [PMID: 30487041]
[19]
Yan, T.; Goldman, R.D. Probiotics for antibiotic-associated diarrhea in children. Can. Fam. Physician, 2020, 66(1), 37-39.
[20]
Leekha, S.; Terrell, C.L.; Edson, R.S. General principles of antimicrobial therapy. Mayo Clin. Proc., 2011, 86(2), 156-167.
[http://dx.doi.org/10.4065/mcp.2010.0639] [PMID: 21282489]
[21]
Abdullatif, V.A.; Sur, R.L.; Eshaghian, E.; Gaura, K.A.; Goldman, B.; Panchatsharam, P.K.; Williams, N.J.; Abbott, J.E. Efficacy of probiotics as prophylaxis for urinary tract infections in premenopausal women: A systematic review and meta-analysis. Cureus, 2021, 13(10), e18843-e18843.
[http://dx.doi.org/10.7759/cureus.18843] [PMID: 34671514]
[22]
Divyaswathi, C.S. Gourishankar, A Lactobacillus causing urinary tract infection in a neonate. J. Med. Cases, 2013, 4(10), 682-685.
[23]
Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; Chou, R.; Glanville, J.; Grimshaw, J.M.; Hróbjartsson, A.; Lalu, M.M.; Li, T.; Loder, E.W.; Mayo-Wilson, E.; McDonald, S.; McGuinness, L.A.; Stewart, L.A.; Thomas, J.; Tricco, A.C.; Welch, V.A.; Whiting, P.; Moher, D. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Rev. Esp. Cardiol. (Engl. Ed.), 2021, 74(9), 790-799.
[http://dx.doi.org/10.1016/j.rec.2021.07.010] [PMID: 34446261]
[24]
Hardin, A.P.; Hackell, J.M.; Simon, G.R.; Boudreau, A.D.A.; Baker, C.N.; Barden, G.A., III; Meade, K.E.; Moore, S.B.; Richerson, J. Age limit of pediatrics. Pediatrics, 2017, 140(3), e20172151.
[http://dx.doi.org/10.1542/peds.2017-2151] [PMID: 28827380]
[25]
Kjaergard, L.L.; Villumsen, J.; Gluud, C. Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann. Intern. Med., 2001, 135(11), 982-989.
[http://dx.doi.org/10.7326/0003-4819-135-11-200112040-00010] [PMID: 11730399]
[26]
Jadad, A.R.; Moore, R.A.; Carroll, D.; Jenkinson, C.; Reynolds, D.J.; Gavaghan, D.J.; McQuay, H.J. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control. Clin. Trials, 1996, 17(1), 1-12.
[http://dx.doi.org/10.1016/0197-2456(95)00134-4] [PMID: 8721797]
[27]
Dani, C.; Biadaioli, R.; Bertini, G.; Martelli, E.; Rubaltelli, F.F. Probiotics feeding in prevention of urinary tract infection, bacterial sepsis and necrotizing enterocolitis in preterm infants. A prospective double-blind study. Biol. Neonate, 2002, 82(2), 103-108.
[http://dx.doi.org/10.1159/000063096] [PMID: 12169832]
[28]
Ghassemi, K.; Montazeri, S.; Moghateli, M.S.; Shakibazad, N.; Fariborzi, M. Use of probiotics for prophylaxis of urinary tract infection recurrence in children; a randomized controlled trial. Ann. Rom. Soc. Cell Biol., 2021, 20767-20772.
[29]
Honeycutt, T.C.; El Khashab, M.; Wardrop, R.M., III; McNeal-Trice, K.; Honeycutt, A.L.; Christy, C.G.; Mistry, K.; Harris, B.D.; Meliones, J.N.; Kocis, K.C. Probiotic administration and the incidence of nosocomial infection in pediatric intensive care: A randomized placebo-controlled trial. Pediatr. Crit. Care Med., 2007, 8(5), 452-458.
[http://dx.doi.org/10.1097/01.PCC.0000282176.41134.E6] [PMID: 17693918]
[30]
Kumar, S.; Bansal, A.; Chakrabarti, A.; Singhi, S. Evaluation of efficacy of probiotics in prevention of candida colonization in a PICU-a randomized controlled trial. Crit. Care Med., 2013, 41(2), 565-572.
[http://dx.doi.org/10.1097/CCM.0b013e31826a409c] [PMID: 23361033]
[31]
Kumar, S.; Singhi, S.; Chakrabarti, A.; Bansal, A.; Jayashree, M. Probiotic use and prevalence of candidemia and candiduria in a PICU. Pediatr. Crit. Care Med., 2013, 14(9), e409-e415.
[http://dx.doi.org/10.1097/PCC.0b013e31829f5d88] [PMID: 23965638]
[32]
Lee, S.J.; Cha, J.; Lee, J.W. Probiotics prophylaxis in pyelonephritis infants with normal urinary tracts. World J. Clin. Pediatr., 2016, 12(4), 425-429.
[http://dx.doi.org/10.1007/s12519-016-0013-2] [PMID: 27059742]
[33]
Lee, S.J.; Lee, J.W. Probiotics prophylaxis in infants with primary vesicoureteral reflux. Pediatr. Nephrol., 2015, 30(4), 609-613.
[http://dx.doi.org/10.1007/s00467-014-2988-z] [PMID: 25354903]
[34]
Lee, S.J.; Shim, Y.H.; Cho, S.J.; Lee, J.W. Probiotics prophylaxis in children with persistent primary vesicoureteral reflux. Pediatr. Nephrol., 2007, 22(9), 1315-1320.
[http://dx.doi.org/10.1007/s00467-007-0507-1] [PMID: 17530295]
[35]
Mohseni, M.J.; Aryan, Z.; Emamzadeh-Fard, S.; Paydary, K.; Mofid, V.; Joudaki, H.; Kajbafzadeh, A.M. Combination of probiotics and antibiotics in the prevention of recurrent urinary tract infection in children. Iran. J. Pediatr., 2013, 23(4), 430-438.
[PMID: 24427497]
[36]
Rojas, M.A.; Lozano, J.M.; Rojas, M.X.; Rodriguez, V.A.; Rondon, M.A.; Bastidas, J.A.; Perez, L.A.; Rojas, C.; Ovalle, O.; Garcia-Harker, J.E.; Tamayo, M.E.; Ruiz, G.C.; Ballesteros, A.; Archila, M.M.; Arevalo, M. Prophylactic probiotics to prevent death and nosocomial infection in preterm infants. Pediatrics, 2012, 130(5), e1113-e1120.
[http://dx.doi.org/10.1542/peds.2011-3584] [PMID: 23071204]
[37]
Sadeghi-Bojd, S.; Naghshizadian, R.; Mazaheri, M.; Ghane Sharbaf, F.; Assadi, F. Efficacy of probiotic prophylaxis after the first febrile urinary tract infection in children with normal urinary tracts. J. Pediatric Infect. Dis. Soc., 2020, 9(3), 305-310.
[http://dx.doi.org/10.1093/jpids/piz025] [PMID: 31100124]
[38]
Cetin, N.; Yildiz, B.; Dinleyici, E.C.; Kural, N. The usefulness of'saccharomyces Boulardii'in treatment and prophylaxis of urinary tract infection in children. Eds.Pediatric nephrology; Springer: 233 SPRING ST, New York, NY 10013 USA, 2014, 29, p. (9)1805.
[39]
Groah, S.L.; Rounds, A.K.; Ljungberg, I.H.; Sprague, B.M.; Frost, J.K.; Tractenberg, R.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., 2019, 11, 1756287219875594.
[http://dx.doi.org/10.1177/1756287219875594] [PMID: 31620195]
[40]
Beyitler, I.; Kavukcu, S. Probiotics for prophylaxis and treatment of urinary tract infections in children. Iran. J. Pediatr., 2017, 27(2)
[http://dx.doi.org/10.5812/ijp.7695]
[41]
Grin, P.M.; Kowalewska, P.M.; Alhazzan, W.; Fox-Robichaud, A.E. Lactobacillus for preventing recurrent urinary tract infections in women: Meta-analysis. Can. J. Urol., 2013, 20(1), 6607-6614.
[PMID: 23433130]
[42]
Meena, J.; Thomas, C.C.; Kumar, J.; Raut, S.; Hari, P. Non-antibiotic interventions for prevention of urinary tract infections in children: A systematic review and meta-analysis of randomized controlled trials. Eur. J. Pediatr., 2021, 180(12), 3535-3545.
[http://dx.doi.org/10.1007/s00431-021-04091-2] [PMID: 34156540]
[43]
Hosseini, M.; Yousefifard, M.; Ataei, N.; Oraii, A.; Mirzay Razaz, J.; Izadi, A. The efficacy of probiotics in prevention of urinary tract infection in children: A systematic review and meta-analysis. J. Pediatr. Urol., 2017, 13(6), 581-591.
[http://dx.doi.org/10.1016/j.jpurol.2017.08.018] [PMID: 29102297]
[44]
Schwenger, E.M.; Tejani, A.M.; Loewen, P.S. Probiotics for preventing urinary tract infections in adults and children. Cochrane Database Syst. Rev., 2015, 2015(12), CD008772.
[http://dx.doi.org/10.1002/14651858.CD008772.pub2] [PMID: 26695595]
[45]
Tang, J. Microbiome in the urinary system-a review. AIMS Microbiol., 2017, 3(2), 143-154.
[http://dx.doi.org/10.3934/microbiol.2017.2.143] [PMID: 31294154]
[46]
Gajdács, M.; Urbán, E. Resistance trends and epidemiology of Citrobacter-Enterobacter-Serratia in urinary tract infections of inpatients and outpatients (RECESUTI): A 10-year survey. Medicina (Kaunas), 2019, 55(6), 285.
[http://dx.doi.org/10.3390/medicina55060285] [PMID: 31216725]
[47]
Brubaker, L.; Wolfe, A.J. The new world of the urinary microbiota in women. Am. J. Obstet. Gynecol., 2015, 213(5), 644-649.
[http://dx.doi.org/10.1016/j.ajog.2015.05.032] [PMID: 26003055]
[48]
Lemberger, U.; Quhal, F.; Bruchbacher, A.; Shariat, S.F.; Hiess, M. The microbiome in urinary tract infections in children - an update. Curr. Opin. Urol., 2021, 31(2), 147-154.
[http://dx.doi.org/10.1097/MOU.0000000000000858] [PMID: 33449574]
[49]
Kilis-Pstrusinska, K.; Rogowski, A.; Bienkowski, P. Bacterial colonization as a possible source of overactive bladder symptoms in pediatric patients: A literature review. J. Clin. Med., 2021, 10(8), 1645.
[http://dx.doi.org/10.3390/jcm10081645] [PMID: 33924301]
[50]
Schaffer, J.N.; Pearson, M.M. Proteus mirabilis and urinary tract infections. Microbiol. Spectr., 2015, 3(5), 3.5.10.
[http://dx.doi.org/10.1128/microbiolspec.UTI-0017-2013] [PMID: 26542036]
[51]
Martín-Muñoz, M.F.; Fortuni, M.; Caminoa, M.; Belver, T.; Quirce, S.; Caballero, T. Anaphylactic reaction to probiotics. Cow’s milk and hen’s egg allergens in probiotic compounds. Pediatr. Allergy Immunol., 2012, 23(8), 778-784.
[http://dx.doi.org/10.1111/j.1399-3038.2012.01338.x] [PMID: 22957765]
[52]
Hojsak, I; Fabiano, V; Pop, TL 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), 2018, 107(6)), 927-937.
[53]
Markowiak, P. Śliżewska, K. Effects of probiotics, prebiotics, and synbiotics on human health. Nutrients, 2017, 9(9), 1021.
[http://dx.doi.org/10.3390/nu9091021] [PMID: 28914794]
[54]
Ailioaie, L.M.; Litscher, G. Probiotics, photobiomodulation, and disease management: Controversies and challenges. Int. J. Mol. Sci., 2021, 22(9), 4942.
[http://dx.doi.org/10.3390/ijms22094942] [PMID: 34066560]

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