Main Article Content
cause of fever in children. Less frequent disposable diaper changing
is thought to be a cause ofUTI in children. While wearing a diapei;
the perinea! area becomes damp with urine allowing bacteria to
migrate from the anus to the external urethral orifice.
Objective To assess for an association between the frequency
of disposable diaper changing and urinary tract infections in
Methods This cross-sectional study was conducted in the
children's outpatient clinic of Haji Adam Malik Hospital from
April to June 2010. Urine culture was performed in children with
suspected UTI who wore disposable diapers every day. Subjects'
ages ranged from 2 months to 2 years 6 months, with samples
matched and collected by consecutive sampling. Diagnosis ofUTI
was based on urine cultures with bacterial count 2:: 105/mL. Eighty
children were followed in this study and divided into two groups:
positive (n=40) and negative (n=40) urine cultures. Chi square
test was use d to analyze the association between the frequency of
daily disposable diapers changing during a one week period and
the urine culture results.
Results The frequency of daily disposable diapers changing in
80 subjects was as follows: < 4 times (22.5%), 4-5 times (40%),
and 2::6 times (37.5%) . The frequency of daily disposable diaper
changing in children with positive urine culture was as fo llows:
< 4 times (1 8 out of 40), 4-5 times (22 out of 40), and 2::6 times
(O out of 40); (P < 0.0001). The most common bacterial species
found in urine cultures was Escherichia coli.
Conclusion Lower frequency of daily disposable diaper changing
is significantly associated with higher UTI incidence in children.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
H, Tambunan T, Prihono PP, Pardede SO, editors. Buku ajar
nefrologi anak. 2nd ed. Jakarta: Gaya Baru; 2006. p. 142-
2. Jarvis A, Scolnik D. A clinical perspective on diagnosis of
urinary tract. CJEM. 2000;2:201-2.
3. Zorc JJ, Kiddoo DA, Shaw KN. Diagnosis and management
of pediatric urinary tract infections. Clin Microbiol Rev.
4. Montini G, Rigon L, Zucchetta P, Fregonese F, Toffolo A,
Gobber D, et al. Prophylaxis after first febrile urinary tract
infection in children? A multicenter, randomized, controlled,
noninferiority trial. Pediatrics. 2008; 122: 1064-7 1.
5. Elder JS. Urinary tract infection. In: Behrman RE, Kliegman
RM, Jenson HB, Stanton BF, editors. Nelson textbook of
pediatrics. lS'hed. Philadelphia: Saunders Elsevier; 2007. p.
6. Novak R, Powell K, Christopher N. Optimal diagnostic testing for urinary tract infection in young children. Pediatr
Dev Pathol. 2004;7:226-30.
7. Whitehall J, Shvartzman P, Miller MA. A novel method for
isolating and quantifying urine pathogens collected from
gel-based diapers. J Fam Pract. 1995;40:476-9.
8. Guidoni EBM, Berezin EN, Nigro S, Santiago NA, Benini
V, Toporovski J. Antibiotic resistance patterns of pediatric
community-acquired urinary infections. Braz J Infect Dis.
9. Al-Mardeni RI, BatarsehA, Omaish L, Shraideh M, Batarseh
B. Empirical treatment for pediatric urinary tract infection
and resistance patterns of uropathogen, in Queen Alia
hospital and prince A'Isha military center-Jordan. Saudi J
Kidney Dis Transplant. 2009;20:135-9.
10. Shaw KN, Gorelick M, McGown KL, Yakscoe NM,
Schwartz JS. Prevalence of urinary tract infection in febrile
young children in the emergency department. Pediatrics.
11. Rao S, Haughton C, Macfarlane P. An improved urine
collection pad method: a randomised clinical trial. Arch Dis
12. Coh en HA, Woloch B, Linder N, Vardi A, Barzilai A. Urine
samples from disposable diapers: an accurate method for urine
cultures. J Fam Pract. 1997 ;44:290-2.
13. Shvartzman P, Nasri Y. Urine culture collected from gel-based
diapers: developing a novel experimental laboratory method.
J Am Board Fam Pract. 2004;17:91-5.
14. Sugimura T, Tananari Y, Ozaki Y, Maena Y, Tanak S, Ito S, et
al. Association between the frequency of disposable diaper
changing and urinary tract infection in infants. Clin Pediatr.
15. Kayiran SM, Eroglu E, Kayiran P, Sazak S, Gurakan B.
Meconium/stool and urinary patterns of healthy newborns.
Marmara Med]. 2012;25:143-7.
16. Mota DM, Barros AJD. Toilet training: methods, parental
expectations and associated dysfunctions. J Pediatri (Rio J).
17. Fonseca EMGO. Diaper removal and difficulties in acquiring
continence. J Pediatr (Rio J) . 2008;28 l:l-2.
18. Fahimzad A, Taherian M, Dalirani Z, Shamshiri A. Diaper
type as a risk factor in urinary tract infection of children. Iran
J Pediatr. 2010;20:97-100.
19. Bergsten G, Wullt B, Svanborg C. Escherichia coli, fimbriae,
bacterial persistence and host response induction in the
human urinary tract. Int J Med Microbiol. 2005;295:487-
20. Raksha R, Srinivasa H, Macaden RS. Occurren ce and
characterization of uropathogenic Escherichia coli in urinary