Proteus urinary infections in childhood.

Quantitative urine culture by the dipinoculum technique of Mackey and Sandys (1965) has shown that the pattern of infection in male children is quite different from that of female children. Among boys under the age of 14 Proteus mirabilis is the causative organism in about 75% of cases of active urinary infection. By contrast only 15% of infection in girls is due to Proteus, the dominant pathogen being Esch. coli. Proteus mirabilis was found in the preputial sacs of 20/51 boys under 10, without overt urinary infection. In nine instances preputial infestation was associated with the presence of Proteus in urine collected without retraction of the foreskin. Although the degree of bacteriuria arising in this way should not often reachlevels typical of active infection, nevertheless infestation of the prepuce by Proteus may be the source of active infection in boys, thus providing a reason for the contrasting incidence of Proteus infection in the two sexes.