Pediatric Department and Infectious Diseases Unit, Shaare Zedek Medical Center Affiliated with Hebrew University-Hadassah School of Medicine, P.O.B. 3235, Jerusalem, Israel.
Hadassah School of Medicine, Jerusalem, Israel.
Int Urol Nephrol. 2020 Mar;52(3):417-422. doi: 10.1007/s11255-019-02352-6. Epub 2019 Nov 29.
Urinary tract infections (UTIs) are common serious bacterial infections in early infancy. Ritual circumcision in neonates may increase the risk of UTI within 2 weeks of the procedure. The aims of this study were to assess the prevalence and risk factors for vesicoureteral reflux (VUR) among young infants with first UTI following circumcision, and compare it with the prevalence of VUR among young infants with first UTI not related to circumcision.
In this retrospective cohort study, the medical records of all children aged 0-100 days who were diagnosed with UTI at Shaare Zedek Medical Center between 2005 and 2012 were reviewed for demographic, clinical and laboratory data and for the presence of VUR in voiding cystourethrography (VCUG).
Four hundred and sixty eight cases of UTI were included. Infants with post-circumcision UTI in our study were more likely to have associated bacteremia and abnormal renal function tests. VCUG was done for 166 infants (35%). There was no statistically significant difference in the prevalence of abnormal VCUG between infants with UTI following circumcision, in comparison to infants with UTI not following circumcision (30% vs. 36%, p = NS).
The decision regarding the need for radiographic evaluation and prophylactic antibiotic treatment following UTI should be made regardless if infection was related to circumcision.
尿路感染(UTI)是婴儿早期常见的严重细菌感染。新生儿行常规包皮环切术可能会增加术后 2 周内发生 UTI 的风险。本研究旨在评估行包皮环切术后首次 UTI 的婴儿中膀胱输尿管反流(VUR)的患病率和危险因素,并与与包皮环切术无关的首次 UTI 婴儿中 VUR 的患病率进行比较。
在这项回顾性队列研究中,回顾了 2005 年至 2012 年在 Shaare Zedek 医疗中心诊断为 UTI 的 0-100 天龄儿童的所有病历,以获取人口统计学、临床和实验室数据,并在排尿性膀胱尿道造影(VCUG)中评估 VUR 的存在。
共纳入 468 例 UTI。与本研究中包皮环切术后 UTI 相关的婴儿更有可能伴有菌血症和肾功能检查异常。对 166 名婴儿进行了 VCUG(35%)。与未行包皮环切术的 UTI 婴儿相比,行包皮环切术的 UTI 婴儿中异常 VCUG 的患病率无统计学差异(30%比 36%,p=NS)。
无论感染是否与包皮环切术有关,均应根据需要决定是否进行放射性检查和预防性抗生素治疗。