Researchers Identify Potential Risk Factors for Urinary Tract Infections in Young Girls

Researchers have identified that young girls with an intense, red, itchy rash on their outer genital organs are at potential risk of developing urinary tract infections (UTIs).

Urinary tract infections are the second most common reason for which people visit doctors every year. They are very common in women, babies and the elderly and are mostly caused by bacteria called Escherichia coli (E.coli). Infection occurs when this bacteria enters the urethra and then the bladder. This condition causes a lot of pain and discomfort.

The latest study, led by researchers at the Wake Forest Baptist Medical Center, found that young girls with intense, red, itchy rash on their outer genital organs face an increased risk of developing urinary tract infection. The simple treatment for this is to maintain good hygiene and abstain from using bubble baths and swimming pools.

"Vulvitis is a common condition affecting women and girls of all ages," said senior author Steve J. Hodges, M.D., associate professor of urology at Wake Forest Baptist. "We found that girls with vulvitis were at least eight times more likely to have a lab-diagnosed UTI than girls without vulvitis, suggesting that vulvitis is a major contributor to UTIs in young girls."

According to the researchers, vulvitis may trigger UTIs by changing the type of bacteria tha t is generally found in the region between the vagina and the anus.

One of the common gynecological conditions occurring in pre-menstrual girls is vulvitis - one of the greatest reasons why they consult the pediatric gynecologist specialist. In postmenopausal women, vulvitis changes the type of bacteria that grips on the cells that line the vagina and up the risk of UTIs. Due to this, the researchers suspect a link between vulvitis and UTIs in pre-menstrual girls.

The finding is based on the examination of 101 toilet-trained girls aged between 2-8 years who reported having symptoms of UTI like urinary frequency, urgency, pain, hesitancy and night wetting. In this study, urine sample of the children was cultured and a 'swab' from the genital area was evaluated in the lab. They noticed that over 57 percent of the girls were suspected of having UTIs and they also displayed signs of vulvitis. The urine analyses revealed that 35 percent of 101 patients had UTI and 86 percent of them had vulvitis.

Nearly 79 percent of the girls with vulvitis had organisms that were commonly associated with UTIs like e-coli. Those without vulvitis were more likely to have bacteria that were not linked with UTIs.

Based on this, the researchers hypothesize that inflammation linked with vulvitis initiates the process that can trigger UTIs.

Hodges said, "Inflammation perturbs the normal bacteria in the area and may allow "competing" UTI-causing bacteria to colonize. Exposure to bubble baths, swimming pool water, urine, feces - all combined with suboptimal hygiene -- contribute to a pro-inflammatory environment."

Hodges noted that there has previously been a lot of anecdotal evidence on pools and baths causing UTIs. "With this study, we have found a plausible cause of that relationship as irritation from certain pools or baths may increase the colonization of certain bacteria."  

The study was documented in Therapeutic Advances in Urology.