Bagga A
Division of Pediatric Nephrology, AU India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Indian J Pediatr. 2001 Jul;68 Suppl 3:S40-5.
Urinary tract infections (UTI) are the second most common bacterial infection in children after those of the respiratory tract. These infections are important in view of their acute morbidity and the long-term risk of renal scarring. Occurrence of UTI below two years of age, delay in starting treatment and presence of vesicoureteric reflux or obstruction are the chief risk factors associated with renal scarring. The classical features of UTI are absent in young children, who often present with few signs or symptoms other than fever. Since the diagnosis of UTI warrants a thorough evaluation subsequently, empiric treatment based on symptoms or urinalysis alone should be avoided. Therapy with appropriate antibiotics is started only after obtaining a urine culture. The distinction between upper and lower urinary tract infections is difficult and the choice of therapy guided by the patient's age and severity of clinical manifestations. All children with UTI should be investigated to identify those with an underlying urinary tract anomaly.
尿路感染（UTI）是儿童中仅次于呼吸道感染的第二常见细菌感染。鉴于其急性发病率和肾瘢痕形成的长期风险，这些感染很重要。两岁以下儿童发生UTI、开始治疗延迟以及存在膀胱输尿管反流或梗阻是与肾瘢痕形成相关的主要危险因素。幼儿UTI的典型特征并不明显，除发热外，他们通常很少有体征或症状。由于UTI的诊断随后需要进行全面评估，应避免仅基于症状或尿液分析进行经验性治疗。只有在获得尿培养结果后才开始使用适当的抗生素进行治疗。区分上尿路感染和下尿路感染很困难，治疗选择由患者年龄和临床表现的严重程度决定。所有UTI患儿都应进行检查，以确定那些存在潜在尿路异常的患儿。
