Jiang Dapeng,Wang Qi,Shi Zhengzhou,et al.Pathogenic characteristics of primary vesicoureteral reflux in infants aged under 2 months with febrile urinary tract infection[J].Journal of Clinical Pediatric Surgery,,18():825-829.[doi:10.3969/j.issn.1671-6353.2019.10.005]
Pathogenic characteristics of primary vesicoureteral reflux in infants aged under 2 months with febrile urinary tract infection
- CLC:
- R726.9;R693;R695
- Abstract:
- Objective To explore the pathogenic characteristics of primary vesicoureteral reflux (VUR) in febrile urinary tract infection (UTI) infants aged under 2 months and evaluate the necessity of voiding cystourethrography (VCUG).Methods Children aged under 2 months with febrile UTI between December 2013 to December 2018 were reviewed.The clinical data were collected and the clinical characteristics summarized for providing theoretical rationales for clinical diagnosis and treatment of VUR.Results A total of 72 infants (<2 months) with febrile UTI fulfilling the inclusion criteria were collected.Escherichia coli was the most common organism.Ultrasound hinted at abnormal urinary system in 28 (38.9%) cases and there were 3 cases of ureteral dilatation.Mild to moderate hydronephrosis was the most common ultrasonographic manifestation.A total of 38 children received VCUG and there were 10 cases of primary VUR.The detection rate of VUR in children infected with Escherichia coli, Enterococcus faecium and Klebsiella pneumoniae was 5.6%, 37% and 42.9%, respectively. There was a significant difference between the detection rate of VUR in UTI cases infected with Escherichia coli and non-Escherichia coli (P=0.03). There was no significant difference (P=0.650).Conclusion Infants (< 2 months) with febrile UTI are less likely to have an abnormal VCUG.The clinical significance of VCUG is great in infants with ultrasonic evidence of severe renal abnormalities and neonates aged <1 month during the first UTI attack.Febrile UTI in infants aged under 2 months caused by non-Escherichia coli should be more active in choosing whether VCUG should be performed or not.
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Memo
收稿日期:2019-09-16。
基金项目:上海市自然科学基金（编号：19ZR1432800）
通讯作者:孙杰,Email:sunjie@scmc.com.cn