ESPU Congress 2018 - Abstract Book

61 11–14 APRIL, 2018, HELSINKI, FINLAND 09:25–09:28 S5-8 (PP) THE INCIDENCE AND RISK FACTORS OF BREAKTHROUGH URINARY TRACT INFECTION AND URINARY TRACT INFECTION AFTER STOPPING CONTINUOUS ANTIBIOTIC PROPHYLAXIS IN CHILDREN WITH PRIMARY VESICOURETERAL REFLUX Michiko NAKAMURA  1 , Kimihiko MORIYA  2 , Yoko NISHIMURA  2 , Masafumi KON  2 , Yukiko KANNO  2 , Takeya KITTA  2 and Nobuo SHINOHARA  2 1) Hokkiado University Graduate School of Medicine, Department of Renal and Genitourinary Surgery, Sapporo, JAPAN - 2) Hokkaido University Graduate School of Medicine, Renal and Genitourinary Surgery, Sapporo, JAPAN INTRODUCTION Our strategy for management of primary vesicoureteral reflux (VUR) is basically active surveillance. Continuous antibiotic prophylaxis (CAP) is indicated for all children with VUR. We retrospectively investigated the incidence and risk factors of urinary tract infection (UTI) during and after CAP in children with primary VUR. PATIENTS AND METHODS Among children with primary VUR, we included children who had first detected VUR before 36 months old in this study. VUR was classified into 5 grades, and high grade reflux was defined as grade 4 and 5. Statistical analysis was performed by Cox's proportional hazard regression model. P<0.05 was considered significant. RESULTS Of 240 children with primary VUR, 203 children (152 boys and 51 girls) were enrolled in the present study. Median age at initial evaluation was 5.6 months old, and median follow up was 5.2 years. Presenting symptom was mainly febrile UTI. CAP was administered in 196 children. Breakthrough UTI was detected in 51 children (26.0 %). Breakthrough UTI occurred within 20 months begin- ning CAP. Median age at stopping CAP was 24.1 months old. Of 126 children after stopping CAP, UTI was detected in 27 (21.4 %). Median age of UTI after stopping CAP was 45.7 months old. On multivariate analysis, risk factor of breakthrough UTI was high grade VUR on initial evalua- tion (p=0.0202). On the other hand, risk factors of UTI after stopping CAP were girls (p=0.0408) and abnormal findings of DMSA scan (p=0.0383). UTI during follow up had occurred within age of 10 years. CONCLUSIONS We revealed that high grade VUR was risk factor for breakthrough UTI, and girls and abnormal findings on DMSA scan were risk factors for UTI after stopping CAP. Longer administration of CAP or prophylactic surgery before recurrent UTI should be indicated in patients with these risk factors. 09:28–09:37 Discussion