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儿童尿路感染的管理要点。

Highlights for management of a child with a urinary tract infection.

作者信息

Habib Sabeen

机构信息

Department of Pediatrics, LSUHealth Shreveport, Shreveport, LA 71130, USA.

出版信息

Int J Pediatr. 2012;2012:943653. doi: 10.1155/2012/943653. Epub 2012 Jul 19.

Abstract

Urinary tract infections remain the most common bacterial infection in childhood. Escherichia coli is responsible for over 80% of Pediatric UTIs. Other common gram negative organisms include Kleibsiella, Proteus, Enterobacter and occasionally Pseudomonas. Signs and symptoms vary greatly by age of the patient becoming more specific as the child grows older. Even in the absence of specific signs a UTI should be included in the differential diagnosis of high grade fever. In younger children, presence of upper respiratory infections, otitis media or gastroenteritis does not eliminate the possibility of a UTI. Culture of the urine remains the gold standard for diagnosing UTIs. All males and females with well documented UTIs should be imaged for the presence of urological anomalies associated with UTI. Depending on patient's clinical symptoms and tolerance, therapy can be oral or parenteral as they have both been found equally efficacious. Healthcare professionals should ensure that when a child or young person has been identified as having a suspected UTI, they and their parents are given information about the need for treatment, the importance of completing any course of treatment and advice about prevention and possible long-term management.

摘要

尿路感染仍然是儿童时期最常见的细菌感染。大肠杆菌导致超过80%的儿童尿路感染。其他常见的革兰氏阴性菌包括克雷伯菌、变形杆菌、肠杆菌,偶尔还有假单胞菌。症状和体征因患者年龄而异,随着孩子年龄增长会变得更加具体。即使没有特定体征,在高热的鉴别诊断中也应考虑尿路感染。在幼儿中,存在上呼吸道感染、中耳炎或肠胃炎并不能排除尿路感染的可能性。尿液培养仍然是诊断尿路感染的金标准。所有确诊尿路感染的男性和女性都应进行影像学检查,以确定是否存在与尿路感染相关的泌尿系统异常。根据患者的临床症状和耐受性,治疗可以是口服或胃肠外给药,因为两者疗效相当。医疗保健专业人员应确保,当确定儿童或年轻人疑似患有尿路感染时,要向他们及其父母提供有关治疗必要性、完成任何疗程的重要性以及预防和可能的长期管理建议的信息。

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