Department of Pediatrics, Clinical Science Institute, Sahlgrenska Academy, University of Gothenburg, Gothenburg 416 85, Sweden; Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg 416 85, Sweden.
Department of Pediatrics, Clinical Science Institute, Sahlgrenska Academy, University of Gothenburg, Gothenburg 416 85, Sweden; Pediatric Uro-Nephrologic Center, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg 416 85, Sweden.
Pediatr Clin North Am. 2022 Dec;69(6):1099-1114. doi: 10.1016/j.pcl.2022.07.003. Epub 2022 Oct 29.
Symptoms of urinary tract infection (UTI) in young children are nonspecific and urine sampling is challenging. A safe and rapid diagnosis of UTI can be achieved with new biomarkers and culture of clean-catch urine, reserving catheterization or suprapubic aspiration for severely ill infants. Most guidelines recommend ultrasound assessment and use of risk factors to direct further management of children at risk of kidney deterioration. The increasing knowledge of the innate immune system will add new predictors and treatment strategies to the management of UTI in children. Long-term outcome is good for the majority, but individuals with severe scarring can develop hypertension and decline in kidney function.
儿童尿路感染(UTI)的症状是非特异性的,尿液采样具有挑战性。使用新的生物标志物和清洁尿培养可以安全、快速地诊断 UTI,仅在严重患病婴儿中保留导尿或耻骨上抽吸。大多数指南建议进行超声评估并使用危险因素来指导有肾脏恶化风险的儿童的进一步管理。先天免疫系统的不断增加的知识将为儿童 UTI 的管理增加新的预测因素和治疗策略。大多数情况下,长期预后良好,但严重瘢痕形成的个体可能会发展为高血压和肾功能下降。