Pediatrics, Akdeniz University, 07070 Antalya, Turkey.
Pediatr Nephrol. 2011 Oct;26(10):1837-41. doi: 10.1007/s00467-011-1889-7. Epub 2011 Apr 26.
In infants with ureteropelvic junction obstruction (UPJO), the risk of urinary tract infection (UTI) is unknown, and there is a lack of prospective studies showing definitive evidence regarding the benefits and necessity of antibiotic prophylaxis. The aim of this study was to assess the risk of UTI in infants with UPJO and to determine whether the risk varies according to the degree of hydronephrosis. Infants with hydronephrosis detected prenatally or within the postnatal 28th day and who had no previous history of UTI were followed prospectively without antibacterial prophylaxis. Imaging studies were performed according to our Pediatric Uro-Nephrology Study Group protocol. Dimercaptosuccinate (DMSA) scintigraphy was performed in all infants at the end of 1 year of follow-up. Eighty-four infants (56 boys, 28 girls) were included in the study. The distribution of patients in each hydronephrosis grading group was incidentally similar. Within a median follow-up period of 18 (12-24) months, none of the patients had UTI. Furthermore, no pyelonephritic scar was found on DMSA scans in any patient. We conclude that prophylactic antibiotic usage is not indicated in infants with UPJO, regardless of the severity of hydronephrosis, as the risk of UTI is minimal in this population.
在患有肾盂输尿管连接部梗阻 (UPJO) 的婴儿中，尿路 感染 (UTI) 的风险尚不清楚，并且缺乏前瞻性研究来明确证 据表明抗生素预防的益处和必要性。本研究旨在评估 UPJO 婴 儿发生 UTI 的风险，并确定风险是否因肾积水程度而异。患有 产前或出生后 28 天内发现的肾积水且无 UTI 既往史的婴儿， 将前瞻性地进行随访而不进行抗菌预防。根据我们的小儿泌尿 肾科研究组方案进行影像学研究。所有婴儿在随访 1 年后均进 行二巯丁二酸 (DMSA) 闪烁扫描。研究共纳入 84 例婴儿（男 56 例，女 28 例）。患者在每个肾积水分级组中的分布偶然相 似。在中位数为 18 个月（12-24 个月）的随访期间，无患者发生 UTI。此外，在任何患者的 DMSA 扫描中均未发现肾盂肾炎瘢 痕。我们得出结论，对于 UPJO 婴儿，无论肾积水严重程度如 何，预防性使用抗生素均不适用，因为该人群发生 UTI 的风险 极小。
