小儿泌尿系感染300例临床回顾分析

Clinical analysis of 300 cases urinary tract infection in children

目的探讨小儿泌尿系感染的临床特点及致病菌的分布情况,为临床医生治疗该疾病提供理论依据。方法对2002—2012年该院儿科病房收治的300例泌尿系感染患儿的发病特点、实验室检查、治疗及转归进行分析。结果 300例患者,其中有13例因高热、水肿严重直接转上级医院,5例因疑似过敏性紫癜转院,另外5例因家属要求退院。145例尿培养前未应用过药物的患儿尿培养阳性率为62.07%,132例尿培养前应用过药物的患儿尿培养阳性率为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94例,对丁胺卡那霉素和头孢哌酮的敏感率均在90%以上。结论抗生素的提前使用会降低尿培养的阳性率。小儿泌尿系感染的常见致病菌为大肠埃希菌,头孢哌酮可作为治疗该病的首选药物。

Objective To discuss the clinical features and the distribution of pathogens of urinary tract infection in children to provide a theoretical basis for clinicians to treat the disease.Methods The Clinical features,Laboratory tests,treatment and prognosis of 300 cases with urinary infection in our hospital pediatric wards from 2002 to 2012 were retrospectively analyzed and summarized.Results In 300 patients,13 cases because of high fever and severe edema were transferred directly to higher level hospitals,five cases of suspected Henoch-Schonlein purpura were transferred and five cases because of the families request discharged.The positive rate of urine culture of 145 cases unused antibiotic was 62.07% and the positive rate of urine culture of 132 cases used？ antibiotic was 20.45%（P 0.05）,there is significant difference between them.In the results of urine culture,94 cases were Escherichia coli with the more than 90% sensitivity rate of amikacin and cefoperazone.Conclusion Advanced use of antibiotics will reduce the positive rate of urine culture.Escherichia coli is a common pathogens of urinary tract infection in children,cefoperazone is the drug of choice in treating the disease.