Urinary tract infection in infants: the significance of low bacterial count
Urinary tract infection in infants: the significance of low bacterial count
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DOI：
10.1007/s00467-015-3199-y
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发表时间：
2016-02-01
影响因子：
3
通讯作者：
Hansson, Sverker
中科院分区：
文献类型：
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作者：
Swerkersson, Svante;Jodal, Ulf;Hansson, Sverker
在儿童尿路感染（UTI）的国家指南中，使用不同的截止水平来定义菌尿。本研究分析了婴儿UTI中细菌计数与炎症参数、膀胱输尿管反流（VUR）频率、肾损害和复发性UTI之间的关系。我们对430例年龄< 1岁、经耻骨上抽吸诊断为有症状UTI的婴儿进行了一项基于人群的回顾性研究。临床和实验室参数、排尿膀胱尿道造影和（99 m）锝二巯基琥珀酸造影的结果以及复发频率与指标UTI的细菌计数有关。83例（19%）婴儿的细菌计数<100，000菌落形成单位（CFU）/ml，347例（81%）的细菌计数<100，000 CFU/ml。在低细菌组和高细菌组中，VUR（两组均为19%）、肾损伤（17和23%，p = 0.33）和复发性UTI（6和12%，p = 0.17）的频率相似。非E。在低细菌组中，大肠杆菌种类更普遍（19对6%，p = 0.0006），平均C反应蛋白更低（50对79 mg/l，p < 0.0001）。非E。大肠杆菌种类和低炎症反应在低细菌计数的UTI中更普遍。
In national guidelines for urinary tract infection (UTI) in children, different cut-off levels for defining bacteriuria are used. In this study, the relationship between bacterial count in infant UTI and inflammatory parameters, frequency of vesicoureteral reflux (VUR), kidney damage, and recurrent UTI was analyzed.We conducted a population-based retrospective study of 430 infants age < 1 year with symptomatic UTI diagnosed by suprapubic aspiration. Clinical and laboratory parameters, findings on voiding cystourethrography and (99m)technetium dimercapto-succinic acid scintigraphy, and frequency of recurrence were related to bacterial count at the index UTI.Eighty-three (19 %) infants had bacterial counts < 100,000 colony-forming units (CFU)/ml and 347 (81 %) had a parts per thousand yen100,000 CFU/ml. There was similar frequency of VUR (19 % in both groups), kidney damage (17 and 23 %, p = 0.33) and recurrent UTI (6 and 12 %, p = 0.17) in the low and high bacterial group. Non-E. coli species were more prevalent (19 versus 6 %, p = 0.0006) and mean C-reactive protein was lower (50 vs. 79 mg/l, p < 0.0001) in the low bacteria group.UTI with low bacterial count is common and of importance since it may be associated with VUR and renal damage. Non-E. coli species and low inflammatory response were more prevalent in UTI with low bacterial count.