Doğan Gül, İpek Hülya
Pediatric Surgery, Hitit University Faculty of Medicine, Çorum, TUR.
Cureus. 2020 Feb 17;12(2):e7019. doi: 10.7759/cureus.7019.
Aim We aimed to compare the demographic and ultrasound data regarding first-episode urinary tract infections with recurrent infections in children. Methods A total of 509 children aged 0-16 years who were diagnosed to have a urinary tract infection (UTI) as confirmed with positive urinary culture tests were retrospectively investigated. A comparison of baseline parameters, responsible pathogen incidences, and ultrasound findings was made between children who had a single episode of UTI (n=418, 82.1%) with those having second or more recurrent episodes of urinary tract infection (n=91, 17.9%). Results The mean age of children with a single episode of urinary tract infection was significantly lower than those who had recurrent urinary tract infection (5.33±4.38 vs. 7.01±4.83 years, p=0.003). Incidences of Escherichia coli and Enterococcus faecalis was significantly higher in patients with recurrent urinary tract infection than those who had single episode (n=315, 75.4% vs. n=80, 87.9%, p=0.009 and n=8, 1.9% vs. n=9, 9.9%, p<0.001, respectively). An abnormal ultrasound was significantly more common in patients with recurrent urinary tract infection than those who had a single episode (n=41, 54.6% vs. n=59, 22.7%). Increased renal parenchymal echogenicity (p=0.002), bladder cystitis (p=0.01) and hydronephrosis (p<0.001) were significantly more common in patients with recurrent urinary tract infection than those who had a single episode of urinary tract infection. Conclusion Escherichia coli and Enterococcus faecalis were the most common responsible pathogens in recurrent urinary tract infections. Structural changes, such as hydronephrosis and bladder cystitis, are likely to have an important role in the etiology of children with recurrent urinary tract infection.
目的 我们旨在比较儿童首次发作的尿路感染与复发性感染的人口统计学和超声数据。方法 回顾性调查了总共509名0至16岁经尿培养试验阳性确诊患有尿路感染（UTI）的儿童。对单发尿路感染患儿（n = 418，82.1%）与发生两次或更多次复发性尿路感染的患儿（n = 91，17.9%）的基线参数、致病病原体发生率和超声检查结果进行了比较。结果 单发尿路感染患儿的平均年龄显著低于复发性尿路感染患儿（5.33±4.38岁对7.01±4.83岁，p = 0.003）。复发性尿路感染患者中大肠杆菌和粪肠球菌的发生率显著高于单发患者（分别为n = 315，75.4%对n = 80，87.9%，p = 0.009；n = 8，1.9%对n = 9，9.9%，p < 0.001）。复发性尿路感染患者中超声异常明显比单发患者更常见（n = 41，54.6%对n = 59，22.7%）。复发性尿路感染患者中肾实质回声增强（p = 0.002）、膀胱膀胱炎（p = 0.01）和肾积水（p < 0.001）明显比单发尿路感染患者更常见。结论 大肠杆菌和粪肠球菌是复发性尿路感染最常见的致病病原体。肾积水和膀胱膀胱炎等结构变化可能在儿童复发性尿路感染的病因中起重要作用。
