Antibiotic Stewardship and the Diagnosis of UTI in Children With Neurogenic Bladders

It is with great interest that we read the article by Forster et al,1 entitled “Uropathogens and Pyuria in Children With Neurogenic Bladders.” Children with neurogenic bladders are at increased risk of urinary tract infection (UTI) secondary to a variety of factors, including altered immunity, poor bladder function, anatomic abnormalities, and clean intermittent catheterization (CIC). The diagnosis of UTI in children with neurogenic bladder is challenging because of bladder microbial colonization, altered sensation, concurrent bladder inflammation, and a failure of the medical community to accurately define UTI in this population.2 Therefore, we respectfully disagree with the conclusion that … E-mail: adestmaurice{at}mednet.ucla.edu