Urinary Tract Infections in Children

小兒泌尿道感染

邱南昌(Nan-Chang Chiu) ； 黃富源(Fu-Yuan Huang) ； 蔡淳娟(Tsuen-Chiuan Tsai)

《Acta Paediatrica Sinica》 30卷4期 (1989/08) Pp. 225-232

摘要

自民國七十年一月至七十六年十二月在本院兒科住院經尿液細菌培養證實爲泌尿道感染的病童共346例。兩歲以下病童佔85.3%，其男與女之比爲3.0，兩歲以上則爲0.8。281例(81.2%)的檢體是經恥骨上膀胱穿刺取得。臨床上以發燒最爲常見。兩歲以下幼童尚有體重減輕或增加遲緩、餵食困難、腹瀉、躁動不安、黃膽、腹脹等表現;兩歲以上則以頻尿、急尿、遺尿、腰痛及腹痛爲主。血尿和水腫在各年齡層亦可見到。在329例做尿液常規檢查的病人中，有2569例(77.8%)其尿中白血球數目大於五個，233例(70.8%)大於十個。
尿液細菌培養共370人次陽性結果。以E.coli最多，273例佔73.6%。其次依序爲Klebsiella spp. 34例(9.2%)、Proteus spp. 27例(7.3%)、Enterococcus 21例(5.7%)、Enterobacter spp. 9例(2.4%)、Pseudomonas aeruginosa 8例(2.2%)、Citrobacter spp. 7例(1.9%)、Morganella morganii 6例(1.6%)、Acinetobacter spp. 6例(1.6%)，有三例培養出Candida albicans。有26人次培養得兩種細菌，三人次得三種細菌，另有一人得四種細菌。

並列摘要

From January 1981 to December 1987, 346 children with urinary tract infections, proved by urine culture, were admitted to the Department of Pediatrics, Mackay Memorial Hospital. The ratio of male to female was 3.0 in children below 2 years, and 0.8 in children above 2 years, of age. The urine specimens were collected from suprapubic punctures in 281 cases (81.2%).Fever was the most common clinical manifestation. In children below two years old, other common symptoms and signs were body weight loss or poor gain, feeding problems, diarrhea, irritability, jaundice, and abdominal distension. In older children, urinary frequency, dysuria, enuresis, loin and abdominal pain were frequently found. Hematuria and edema were occasionally noted in all age groups. Microscopic examination of 329 centrifuged urine specimens revealed: 256 cases (77.8%) had more than 5 leukocytes per high power field, 233 cases (70.8%) had more than 10 leukocytes.
Three hundred and seventy positive urine cultures were obtained from these patients. E. coli was isolated in 273 cases (73.6%), followed by Klebsiella spp., 34 cases (9.2%); Proteus spp., 27 cases (7.3%); Enterococcus, 21 cases (5.7%); Enterobacter spp., 9 cases (2.4%); Pseudomonas aeruginosa, 8 cases (2.2%); Citrobacter spp., 7 cases (1.9%); Morganella morganii, 6 cases (1.6%); Acinetobacter spp., 6 cases (1.6%); etc. Candida albicans was isolated from three patients. Two organisms were isolated in 26 cultures; 3 organisms, in 3, and 4 in 1.

並列關鍵字

urinary tract infection ； causative organisms ； antibiotic susceptibility