Lohr J A, Downs S M, Dudley S, Donowitz L G
Division of Community Pediatrics, University of North Carolina School of Medicine, Chapel Hill 27599.
Pediatr Infect Dis J. 1994 Jan;13(1):8-12. doi: 10.1097/00006454-199401000-00003.
To determine through a prospective study the characteristics of hospital-acquired urinary tract infections (HAUTI) in children, 525 children subjected to bladder catheterization during a hospital admission were identified through surveillance of 12,316 admissions during a 24-month period. Urine culture results were available for 296 (56.4%) of the catheterized patients. In addition 12 noncatheterized children with a documented HAUTI were identified. The clinical courses of all patients with a HAUTI were followed for at least 6 months after their last HAUTI during the study period. Forty-four patients, 1 week to 17 years of age, with 1 or more HAUTI during a hospital unit admission were identified. A total of 51 HAUTI occurred. Thirty-nine (76.5%) of the infections occurred in patients subjected to catheterization. Thirty-two (10.8%) of 296 catheterized patients developed a HAUTI. Forty-three (84.3%) of the 51 infections were single organism infections. One HAUTI was associated with a wound infection with the same organism and one with a concurrent bacteremia with the same organism. Relapses were seen after 4 HAUTI. One reinfection was identified. There were no deaths directly associated with a HAUTI. Hospitalized children subjected to urinary tract catheterization are at significant risk for HAUTI. Complications are infrequent and not life-threatening.
为通过前瞻性研究确定儿童医院获得性尿路感染（HAUTI）的特征，在24个月期间对12316例住院病例进行监测，识别出525例在住院期间接受膀胱插管的儿童。296例（56.4%）插管患者有尿培养结果。此外，还识别出12例有记录的非插管HAUTI儿童。在研究期间，对所有HAUTI患者的临床病程在其最后一次HAUTI后至少随访6个月。识别出44例年龄在1周至17岁之间、在住院期间发生1次或多次HAUTI的患者。共发生51次HAUTI。其中39次（76.5%）感染发生在接受插管的患者中。296例插管患者中有32例（10.8%）发生了HAUTI。51次感染中有43次（84.3%）为单一微生物感染。1次HAUTI与同一微生物引起的伤口感染相关，1次与同一微生物引起的并发菌血症相关。4次HAUTI后出现复发。识别出1次再感染。没有直接与HAUTI相关的死亡病例。接受尿路插管的住院儿童发生HAUTI的风险很高。并发症很少见，且不危及生命。
