Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Ren Fail. 2013;35(1):66-71. doi: 10.3109/0886022X.2012.741647. Epub 2012 Nov 21.
Recurrent urinary tract infection (UTI) is one of the major health problems in children because of its high rate of occurrence.
Our aim of the study was to evaluate the prevalence and determine risk factors of recurrent UTI in Thai children.
The medical records of children aged less than 15 years diagnosed with UTI at the Department of Pediatrics, Songklanagarind Hospital were reviewed.
A total of 307 children (144 boys, 163 girls) were followed up for at least 1 year. Fifty-six children, 31 (19.0%) boys and 25 (17.4%) girls, developed at least one recurrence totaling 153 recurrent UTI episodes. The recurrence rate was not statistically different between the sexes (p = 0.8). On multivariate analysis, genitourinary system (GU) anomalies, particularly vesicoureteral reflux (VUR), were the most significant risk factors. Children aged greater than 5 years had a slightly higher risk of recurrence, irrespective of gender. Comparison of organisms associated with recurrent UTI with those associated with first UTI showed that the prevalence of Escherichia coli decreased from 76.9% to 56.2% but was still the major causative agent. In contrast, the prevalence of Klebsiella pneumoniae and unusual or mixed organisms significantly increased from 7.8% to 15.0% and 6.2% to 16.3%, respectively.
One-fifth of children who had UTI developed recurrence and the rates were similar for males and females. Independent risk factors for recurrent UTI were found to be at age of >5 years and underlying disease of either GU anomaly or VUR.
复发性尿路感染（UTI）是儿童的主要健康问题之一，因为其发病率很高。
我们研究的目的是评估泰国儿童复发性 UTI 的患病率并确定其危险因素。
回顾性分析在宋卡王子大学医院儿科诊断为 UTI 的年龄小于 15 岁的儿童的病历。
共有 307 名儿童（144 名男孩，163 名女孩）至少随访 1 年。56 名儿童（31 名男孩，25 名女孩）至少发生了 1 次复发，共发生 153 次复发性 UTI。男孩和女孩之间的复发率没有统计学差异（p = 0.8）。多变量分析显示，泌尿生殖系统（GU）异常，特别是输尿管反流（VUR）是最显著的危险因素。无论性别如何，年龄大于 5 岁的儿童复发风险略高。复发性 UTI 相关病原体与首次 UTI 相关病原体的比较表明，大肠杆菌的患病率从 76.9%降至 56.2%，但仍是主要病原体。相比之下，肺炎克雷伯菌和不常见或混合病原体的患病率分别从 7.8%升至 15.0%和从 6.2%升至 16.3%。
五分之一患有 UTI 的儿童发生了复发，男孩和女孩的复发率相似。复发性 UTI 的独立危险因素是年龄大于 5 岁和 GU 异常或 VUR 等基础疾病。
