Korean Journal of Nephrology 1984;3(1):7-18.

소아 요로감염에 대한 임상적 고찰

정해일 , 윤회상 , 최 용 , 고광옥

Abstract

There had been total 100 cases of urinary tract infection who had been admitted to the Ward of Pediatrics, Seoul National University Hospital from Jan. 1980 to Dec. 1983, and they held 1. 21 % of total pediatric inpatiente during the same period. I Among these, 50 patients,were neonates or infants and in these age groups more than S times I of male preponderance(M:F=38: 12) was observed, but in the age groups of over 1 year female pre- ponderance(M:F=22: 28) was observed with resulting total male to female ratio of 60 ' 40. Jn 55 cases, both pyuria and significant bacte- riuria were documented. Among clinical findings of total patients, fever, G-I sy ptoms, irritability, CVA tenderness, dysuria, urinary frequency and dehydration were noted in th order of decreasing frequency, and specific urinary symptoms such as CVA tenderness, dysuria and urinary frequency were more frequent in older age groups. Anemia(Hgb 10.0 gm/dl>) and leukocytosie (WBC count in CBC 10,000<) were noted in 34 and in 71 Cases respectively, and these findings were less frequent in older age groups. Among urinalysis findings, pyuria, hematuria, proteinuria and positive nitrite reaction were noted in 89, 31, 47 and 25 cases respectively, and elevated ESR(2p mm/hrg), reactive serum CRP, elevated serum creatinine level(1.2mg/dl <) and elevated LDH isoensyme type 4 and/or 5 in urine were notad in 88.9% 88.9%, 11.0% and 50.0% respectively. Abnormal findings of IVP(intravenous pyelography) were noted in 37.7%' with a leading one of hydronephrosis and/or hydroureter, and VUR(vesi- coureteral reflux) was noted in 47.2% of cases with VCU(voiding cystourethrography) and the degree of reflux was varJable. In 4 cases among those with VUR, long-term antibiotic therap@y was done and improvement in reflux was noted in cases, Finally, E. coli and Klebsiella species were the most common strains isolated in urine culture. In those without G-U tract abnormalites these strains held about 80%, and in those with G-U tract abnormalities they held about 50% with resulting total frequency of about 70 %.