Mingin Gerald C, Hinds Angie, Nguyen Hiep T, Baskin Laurence S
Department of Urology, University of California, San Francisco, School of Medicine, San Francisco Children's Hospital, San Francisco, California 94143, USA.
Urology. 2004 Mar;63(3):562-5; discussion 565. doi: 10.1016/j.urology.2003.10.055.
To determine the recurrence rate and risk factors for urinary tract infection (UTI) in children who present with a febrile UTI and have a negative radiologic evaluation. Febrile UTIs with no urinary tract abnormalities are a common cause of morbidity in children.
We performed a retrospective review of all children referred to our medical center after a febrile UTI.
We reviewed 850 charts. Of 850 children, 78 had had a febrile UTI and normal ultrasound and voiding cystourography findings. Of the 78 children, 25 had had a recurrent UTI (3 boys and 22 girls). Forty-five percent of the girls with a febrile UTI developed a recurrent UTI and 14% of the boys had a recurrent UTI (P = 0.02). Three boys (two younger than 1 year of age) were uncircumcised and had one recurrent febrile UTI. Eleven (39%) of 28 girls who first presented at younger than 1 year of age and 7 (58%) of 12 girls who presented at 5 years of age or older had recurrent UTIs. The recurrence rate in the 2 to 5-year-old age group was 24% (4 of 17). Seven of the older girls exhibited symptoms of dysfunctional elimination syndrome.
In children with a febrile UTI and a negative radiologic evaluation, recurrence was more common in girls. Boys who were uncircumcised may be at an increased risk of infection during the first year of life. In girls, the age at the time of the first infection was not predictive of recurrence. Although dysfunctional voiding and elimination may contribute to recurrent febrile UTIs in young children, an association seems to be present in children 5 years old and older.
确定发热性尿路感染（UTI）且放射学评估为阴性的儿童中UTI的复发率及危险因素。无尿路异常的发热性UTI是儿童发病的常见原因。
我们对所有因发热性UTI转诊至我们医疗中心的儿童进行了回顾性研究。
我们查阅了850份病历。在850名儿童中，78名曾患发热性UTI且超声和排尿性膀胱尿道造影结果正常。在这78名儿童中，25名曾复发UTI（3名男孩和22名女孩）。发热性UTI的女孩中有45%复发UTI，男孩中有14%复发UTI（P = 0.02）。3名男孩（2名年龄小于1岁）未行包皮环切术，有1次复发性发热性UTI。首次发病年龄小于1岁的28名女孩中有11名（39%）复发UTI，5岁及以上发病的12名女孩中有7名（58%）复发UTI。2至5岁年龄组的复发率为24%（17名中的4名）。年龄较大的女孩中有7名表现出功能性排尿障碍综合征的症状。
在发热性UTI且放射学评估为阴性的儿童中，复发在女孩中更常见。未行包皮环切术的男孩在1岁以内可能感染风险增加。在女孩中，首次感染时的年龄不能预测复发。虽然功能性排尿和排便异常可能导致幼儿复发性发热性UTI，但这种关联似乎在5岁及以上儿童中存在。
