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SMEGMA IS A RISK FACTOR OF URINARY TRACT INFECTION: PROSPECTIVE
COMPARATIVE CONTROL STUDY
Jae Min CHUNG
1
, Dong Il KANG
2
, Dong Wan SHON
3
, Dong Soo RYU
4
, Won Yeol CHO
5
and Sand Don LEE
1
1) Pusan National University Yangsan Hospital, The Department of Urology, Yangsan, KOREA (REPUBLIC OF) - 2) Inje
University, Urology, Busan, KOREA (REPUBLIC OF) - 3) Yeouido St. Mary's Hospital, College of Medicine, The Catholic
University of Korea, The Department of Urology, Seoul, KOREA (REPUBLIC OF) - 4) Changwon Samsung Hospital,
Urology, Chanwon, KOREA (REPUBLIC OF) - 5) Dong-A University Hospital, Urology, Busan, KOREA (REPUBLIC OF)
PURPOSE
The objective of this study is to document the common bacteria found in the smegma in the subpreputial space of
asymptomatic boys, their antimicrobial susceptibility pattern, and to determine if they differ from those commonly
isolated depending on smegma.
MATERIAL AND METHODS
Between August 2014 and December 2014, specimens were collected from a total of 40 boys who presented for repair
of concealed penis or urethroplastyof hypospadiasin our institution. Swab was done using aseptic techniques on smegma
and glans in the operation room. According to the presence of smegma, we classifiedglansas a group S (n=20) (with
smegma) and group C (n=20) (without smegma) following retraction of the prepuce. The swabs were immediately sent
to microbiology laboratory for microscopy, culture, and sensitivity tests.
RESULTS
Age of 40 boys was ranged from 3 months to 9 years 11 months (mean age, 30.4± 26.4months). In smegma, a total of
31 bacterial isolates were made. There were 12 gram-positive bacteria (41.9%) and 19 gram-negative ones (64.5%). A
single isolate was found in 6 boys (30%), 9 had a mixed isolate (35%), 1 had non uropathogen (5%), while no bacteria
was isolatedin 4 boys (20%).The most commonly isolated gram-negative bacteria was Escherichia coli (25.8%), while
the commonly isolated gram-positive bacteria were Enterococcus faecalis (16.1%) and Enterococcus avium (12.9%).
Most of the bacterial isolates were multi-drug-resistant (61.3%).
In group S, 12 boys had 20 bacterial isolates in glans. The most commonly isolated bacteria was Escherichia coli (30%).
In group C, 13 boys had 18 bacterialisolates in glans. The most commonly isolated bacteria was Enterococcus faecalis
(30%).
CONCLUSIONS
Smegma in the subpreputial space of children was colonized by many kind of uropathogen in subpreputial space. E. coli
that is known the most common uropathogen was more frequently colonized in child with smegma than one without
smegma. Therefore smegmamay be arisk factor of urinarty tract infection in children.