Center for Paediatric and Adolescent Medicine, University Medical Clinic, Mainz, Rheinland-Pfalz, Germany.
Curr Opin Pediatr. 2012 Apr;24(2):205-11. doi: 10.1097/MOP.0b013e32834f0423.
The prevalence of urinary tract infections (UTIs) among full-term neonates has been reported to be up to 1.1%, increasing up to 7% among those with fever. UTI in neonates may be the first indicator of underlying abnormalities of kidneys and the urinary tract.
Early recognition and therapy of UTI and detection of risk factors offer chances for applying strategies to avoid renal damage and recurrences. However, established diagnostic strategies and prophylactic concepts today are under debate. Currently, the main focus has been on renal changes as indicators for underlying risk factors like vesicoureteral reflux, attaching much importance to dimercaptosuccinyl acid scans. Serum and urine markers will probably allow more restrictive diagnostic imaging. Prenatal and postnatal ultrasound screenings provide additional opportunities for prophylactic measures.
Main objectives in the management of neonatal UTIs are the prevention of acute infection-related complications and renal damage. Neonates and very young infants with suspicious pyelonephritis should obligatorily be treated with a combination of parenterally administered antibiotics. As far as possible, diagnostic imaging should be risk-oriented and restricted to noninvasive, nonstressful procedures. The strategies of antibacterial prophylaxis for the prevention of recurrent UTIs are changing. In infants at risk, its benefits have not yet been proven by evident data.
足月新生儿尿路感染（UTI）的患病率据报道高达 1.1%，发热患儿中患病率高达 7%。新生儿 UTI 可能是肾脏和泌尿道潜在异常的首个指标。
早期识别和治疗 UTI 并发现危险因素可提供机会，以避免肾脏损伤和复发。然而，目前既定的诊断策略和预防概念仍存在争议。目前，主要关注点是肾脏变化，因为其是诸如膀胱输尿管反流等潜在危险因素的指标，非常重视二巯丁二酸扫描。血清和尿液标志物可能允许更具限制性的诊断成像。产前和产后超声筛查为预防措施提供了额外的机会。
新生儿 UTI 管理的主要目标是预防急性感染相关并发症和肾脏损伤。疑似肾盂肾炎的新生儿和非常年幼的婴儿必须接受肠外给予抗生素的联合治疗。在可能的情况下，诊断成像应针对风险，并限制为非侵入性、无应激的程序。预防复发性 UTI 的抗菌预防策略正在发生变化。在有风险的婴儿中，其益处尚未通过明确的数据证明。
