Vesicovaginal reflux and recurrent urinary tract infection due to ESBL-producing Escherichia coli in the pediatric age group: a case report
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Keywords
Vesicovaginal Reflux, Urinary Tract Infections, Escherichia coli, beta-Lactamases, Extended-Spectrum, Vaginal Microbiota
Abstract
Vesicovaginal reflux (VVR) is a functional disorder characterized by retrograde filling of the vagina during micturition, with urinary incontinence as its main symptom. This condition may alter vaginal pH and microbiota, predisposing to recurrent urinary tract infections (UTIs), particularly in pediatric patients. We report the case of a girl with recurrent UTIs caused by extended-spectrum beta-lactamase (ESBL)–producing Escherichia coli, associated with VVR. The patient underwent multiple diagnostic evaluations, including invasive procedures, and received several antibiotic regimens without definitive resolution. A complementary approach aimed at modulating the vaginal and intestinal microbiota was implemented, including dietary modifications, increased intake of prebiotics and probiotics, and topical administration of boric acid and lactic acid compounds to restore vulvovaginal pH. After six months of intervention, the patient remains asymptomatic, with no recurrences during one year of follow-up. This case suggests that targeted microbiota modulation may help reduce UTI recurrence in girls with VVR and decrease the need for invasive interventions.
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