儿童社区获得性泌尿道感染104例回顾性分析

Retrospective analysis of 104 cases of community-acquired urinary tract infection in children

目的了解儿童社区获得性泌尿道感染的临床特点,提高早期诊断率。方法回顾性分析2012年1月~2016年12月在儿科住院的104例儿童社区获得性泌尿道感染的临床特点、辅助检查及致病菌分布特点。结果 104例患儿临床表现不典型,<2岁儿童以发热为主要表现,尿培养以G-杆菌为主,尤以大肠埃希菌(82例,占78.8%)为主,亦有部分球菌可引起泌尿道感染,但为数不多。泌尿道感染对头孢三代抗生素治疗反应好。部分再发型泌尿道感染行排泄性膀胱输尿管造影检查存在膀胱输尿管反流。结论儿童社区获得性泌尿道感染早期诊断不容易,对于年龄<2岁,以发热为单一表现者,建议早期行尿常规筛查。

Objective To investigate the clinical characteristics of community-acquired urinary tract infection in children so as to improve the early diagnosis rate.Methods The clinical characteristics,auxiliary examinations and pathogenic bacteria distribution of 104 children with community-acquired urinary tract infection hospitalized in our hospital from January 2012 to December 2016 were analyzed retrospectively.Results The clinical manifestations of 104 cases were atypical.The main manifestation of children 〈2 years old was fever,urine cultures were mainly G-bacilli,especially Escherichia coli （82 cases,78.8%）.Some coccus could also cause urinary tract infections,but it only had a small number.The treatment with three-generation cephalosporin antibiotics showed good response to urinary tract infection. Excretory ureter radiography showed the existence of vesicoureteric reflux in partial recurrent urinary tract infection. Conclusion The community-acquired urinary tract infection in children is uneasy to be early diagnosed.Early routine urinalysis is recommended for patients aged 〈2 years with fever as the single manifestation.