Lu Jiandong, Liu Xiaozhu, Wei Yi, Yu Chengjun, Zhao Jie, Wang Ling, Hu Yang, Wei Guanghui, Wu Shengde
Department of Urology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics Chongqing, Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Pediatr. 2022 Apr 7;10:844797. doi: 10.3389/fped.2022.844797. eCollection 2022.
Urinary tract infection (UTI) is a common occurrence in children. UTI and urological malformations are intimately linked. However, whether urinary tract malformations affect the clinical features of pediatric UTI remains unclear. The purpose of this study was to characterize the clinical features and microbial etiology of UTI in children.
We retrospectively reviewed the records of 741 patients with UTI treated at the Chongqing Medical University Affiliated Children's Hospital between 2015 and 2020. Patients with and without urological malformations were compared using propensity score matching (PSM).
was the most common causative microorganism of UTI, accounting for 40.5% of infections. One hundred twenty-two patients (16.5%) had urological malformations. PSM identified 122 matched pairs of patients with or without urological malformations. The proportion of patients with UTI caused by atypical microorganisms was significantly higher in patients with urological malformations ( = 0.048). Children with urological malformations showed longer duration of intravenous antibiotic treatment ( = 0.010), higher cost of treatment ( < 0.001), and higher prevalence of recurrence (23.8 vs. 10.7%, < 0.001), compared with the normal group.
Children with urological malformations are more likely to develop UTI with atypical microorganisms. Appropriate imaging examination and urine culture are strongly recommended for the diagnosis and management of pediatric UTI.
尿路感染（UTI）在儿童中很常见。UTI与泌尿系统畸形密切相关。然而，泌尿系统畸形是否会影响小儿UTI的临床特征仍不清楚。本研究的目的是描述儿童UTI的临床特征和微生物病因。
我们回顾性分析了2015年至2020年在重庆医科大学附属儿童医院接受治疗的741例UTI患者的记录。采用倾向评分匹配（PSM）对有和没有泌尿系统畸形的患者进行比较。
[此处原文缺失具体结果内容]是UTI最常见的致病微生物，占感染的40.5%。122例患者（16.5%）有泌尿系统畸形。PSM确定了122对有或没有泌尿系统畸形的匹配患者。泌尿系统畸形患者中由非典型微生物引起的UTI患者比例显著更高（=0.048）。与正常组相比，有泌尿系统畸形的儿童静脉抗生素治疗时间更长（=0.010），治疗费用更高（<0.001），复发率更高（23.8%对10.7%，<0.001）。
有泌尿系统畸形的儿童更有可能感染非典型微生物引起的UTI。强烈建议对小儿UTI的诊断和管理进行适当的影像学检查和尿培养。
