Moulin F, Quintart A, Sauvestre C, Mensah K, Bergeret M, Raymond J
Service des consultations-urgences, hôpital Saint-Vincent-de-Paul, Paris, France.
Arch Pediatr. 1998;5 Suppl 3:274S-278S. doi: 10.1016/s0929-693x(98)80148-6.
Urinary tract infections (UTI) are the most frequent nosocomial infection in the adult, yet very few data are available concerning these infections in children. In a retrospective 1-year study in a paediatric hospital, we analysed the incidence of nosocomial UTI and the characteristics of the affected children. The incidence was of 1.97/1,000 admissions which represented 6.8% of all UTI diagnosed by the microbiology laboratory. Most cases were in surgery and neurology wards. The frequency was inversely proportional to the age, with 50% of children being less than 2 years old. Pathogens most frequently isolated were E coli (39%), Pseudomonas sp (12.1%) and Enterococcus sp (12.1%). When compared with the organisms found in all the urine cultures during the same period, two organisms were more frequently found in nosocomial urinary tract infections: Pseudomonas sp and Candida sp. Most patients presented one or more risk factors, mainly:bladder catheterisation (41.4%), prior antibiotic therapy (62%), cerebral palsy (6.9%). No bacteriema was observed. The diagnosis of nosocomial UTI must be interpreted with caution and needs close collaboration between microbiologists and paediatricians. These infections increase the cost of hospitalisation, but only exceptionally do they present with complications. Some risk factors are inherent in hospital conditions, but others can be reduced by improving hand washing or by changing catheterisation practices.
尿路感染（UTI）是成人中最常见的医院感染，但关于儿童尿路感染的数据却非常少。在一家儿科医院进行的为期1年的回顾性研究中，我们分析了医院获得性尿路感染的发生率以及受感染儿童的特征。发生率为1.97/1000次住院，占微生物实验室诊断的所有尿路感染的6.8%。大多数病例发生在外科和神经科病房。发病率与年龄成反比，50%的儿童年龄小于2岁。最常分离出的病原体是大肠杆菌（39%）、假单胞菌属（12.1%）和肠球菌属（12.1%）。与同期所有尿培养中发现的微生物相比，医院获得性尿路感染中更常发现两种微生物：假单胞菌属和念珠菌属。大多数患者存在一个或多个危险因素，主要有：膀胱插管（41.4%）、先前的抗生素治疗（62%）、脑瘫（6.9%）。未观察到菌血症。医院获得性尿路感染的诊断必须谨慎解释，需要微生物学家和儿科医生密切合作。这些感染增加了住院费用，但只有极少数情况下会出现并发症。一些危险因素是医院环境所固有的，但其他一些可以通过改善洗手或改变插管操作来降低。
