Association between the frequency of disposable diaper changing and urinary tract infection in children

Meirina Daulay; Rosmayanti Siregar; Oke Rina Ramayani; Supriatmo Supriatmo; Rafita Ramayati; Rusdidjas Rusdidjas

doi:10.14238/pi53.2.2013.70-5

Meirina Daulay Department of Child Health, University of North Sumatera Medical School/H Adam Malik Hospital
Rosmayanti Siregar Department of Child Health, University of North Sumatera Medical School/H Adam Malik Hospital
Oke Rina Ramayani Department of Child Health, University of North Sumatera Medical School/H Adam Malik Hospital
Supriatmo Supriatmo Department of Child Health, University of North Sumatera Medical School/H Adam Malik Hospital
Rafita Ramayati Department of Child Health, University of North Sumatera Medical School/H Adam Malik Hospital
Rusdidjas Rusdidjas Department of Child Health, University of North Sumatera Medical School/H Adam Malik Hospital

DOI: https://doi.org/10.14238/pi53.2.2013.70-5

Keywords: urinary tract infection, diaper changing, urine culture

Abstract

Background Urinary tract infection (UTI) is the most common
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
children.
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.

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