小儿泌尿系感染277例临床分析

Clinical analysis for 277 children with urinary tract infection

目的探讨小儿泌尿系感染的临床特点及致病菌的分布和耐药情况,为临床诊断治疗提供依据。方法对1998—2006年首都医科研究所附属儿童医院肾脏病房收治的277例泌尿系感染患儿的临床特点、实验室检查、治疗及转归进行回顾性分析。结果145例尿培养前未应用过药物的患儿其尿培养阳性率为62.07%,132例培养前应用过药物的患儿其阳性率为20.45%,两者差异有统计学意义(P<0.05)。尿培养结果中大肠埃希菌有94例,对丁胺卡那霉素和头孢西丁的敏感率均在90%以上。结论抗生素的应用会大大降低尿培养的阳性率。大肠埃希菌为泌尿系感染的常见致病菌,头孢西丁可作为小儿泌尿系感染的首选用药。对首次发病的泌尿系感染患儿进行相应的影像学检查以排除一些潜在的病因是十分必要的。

Objective To discuss the clinical features of urinary tract infection and the distribution of the bacteria so as to provide evidence for clinical diagnosis and treatment. Methods The clinical data of 277 children with urinary tract infection were retrospectively analyzed. Results The urine culture＇s positive rate of the patients who had used antibiotics before the test was higher than those who had not used,62. 07% vs. 20. 45% （ P 〈 0. 05 ）. Totally 94 Escherichia coli were found in urine culture. The susceptibility of 94 Escherichia coli to Amikacin Sulfate and Cefoxitin was 95.46% and 90. 91%. Conclusion The use of antibiotics before urine culture will reduce the positive rate. Escherichia coli is commonly seen in urinary tract infection. Cefoxitin could be chosen first in the treatment for children with urinary tract infection. The imaging examination is very important for children who first have urinary tract infection.