Clinical Characteristics And Pathogens Analysis Of 591 Children With Urinary Tract Infection

Objective: To analyze the clinical characteristics,pathogens and drug sensitivity of UTI,so as to help pediatricians better manage UTI in children.Methods: Clinical data of 591 hospitalized children with UTI from Jan.2014 to Feb.2021 were collected and analyzed.Groups according to age and urine culture results.Results:1.The high incidence age of UTI was in the period of infants and school age,with a total of 394 cases(66.7%).Except in infancy,the incidence of UTI was higher in girls than in boys in other groups.2.The basis urinary system diseases associated with UTI were the commonest in infants and school-age groups.The proportion of congenital urinary tract malformations was highest in infants,and the proportion of urinary calculi was the highest in school-age children.Extra-urinary diseases were most common in infant group.3.With the increase of age,most of the non-specific manifestations were found in the cases <3y,while the manifestation of urinary system were found in the cases ≥3y,The clinical manifestations in different age groups was statistically significant(P<0.001)。4.The rate of culture-positive of urine was low(only 17.43%).Only 235cases(39.76%)were performed by imaging examination.5.The results showed that the incidence,clinical manifestations and combined diseases of male and female were statistically significant in different age groups(P<0.05).The commonest pathogens were E.coli and Enterococcus faecium.The proportion of pathogens in 2014～2017 and 2018～2021 was statistically significant(P<0.05).Gram-negative bacteria showed an increasing trend,while Gram-positive bacteria showed a decreasing trend.Compared with2014-2017,the enzyme-producing rate of E.coli decreased during 2018-2021,and the enzyme-producing strains showed higher drug resistance rate than the non-enzyme-producing strains,which were only more than 50% resistant to piperacillin,tetracycline and ampicillin.The resistance rate of the enzyme producing strains to cefuroxime,ceftazidime,cefotaxime and other commonly used cephalosporins,tetracycline and penicillins was higher than 80%,and the resistance rate of some antimicrobials decreased in recent years.The drug resistance rate of Enterococcus faecium to gentamycin and other aminoglycosides and macrolides was higher,and the sensitivity rate to vancomycin,linezolid,daptomycin and macrodantin was higher than 60%.Conclusions: The incidence of urinary tract infection in children was related to gender and age,and the clinical manifestations and co-exist diseases varied with age.When diagnosing UTI in children,it was necessary to take into consideration the clinical manifestations,urine test results and imaging examinations to accurately diagnose UTI.During treatment,etiological changes should be considered,antibiotics should be selected accurately,and precise treatment should be given to improve prognosis.