All issues > Volume 37(11); 1994

Original Article

J Korean Pediatr Soc. 1994;37(11):1488-1499. Published online November 15, 1994.

A Clinical Study on Urinary Tract Infection in Infants and Children

Yoon Hwa YH Cha¹, Hee Ran HR Choi¹, Seong Hee SH Jang¹, Young Min YM Ahn¹

¹Department of Pediatrics, Kangnam Hospital Public Corporation, Seoul, Korea

Abstract

This is a report of clinical study on the 63 patients of symptomatic urinary tract infection who were hospitalized at the Department of Pediatrics in Kangnam General Hospital during the period between the May of 1989 and the September of 1992. The observation results were as follows: 1) The frequency of urinary tract infection (UTI) was the highest in children under the age of one year (66.7%). 35 patients were male, while the other 28 were female. The ratio of male and female patients was 1.25:1. 2) Fever was observed in most of the cases. Systemic nonspecific manifestation was predominant in the infancy and early childhood, whereas local symptom of UTI was predominant in the late childhood. Among the 35 male patients, 32 cases were phimoses. As for the other 3 cases, phimoses were not identified. 3) E. coli had the most frequency (65.3%), followed by Klebsilla, Enterobacter, Pseudomonas in descending order. 4) In the vitro antimicrobial susceptibility test, Gram negative organisms such as E. coli, Klebsiella, Enterobacter were sensitive to cefotaxime, amikacin, and ampicillin/sulbactam. Meanwhile, Gram positive organisms such as Staphylococcus, Enterococcus were sensitive to vancomycin and cephradine. 5) The renal ultrasonography test was performed for 59 patients, 13 cases of whom showed abnormal findings. 6 cases out of the 13 abnormal patients had hydronephrosis. 6) DMSA renal ultrasonography was performed for 40 patients within 2 months of an acute phelonophritic attack. Signs of pyelonephritic change were found in 18 patients. DMSA scan was repeated 4~12 months later in 4 of these patients. This showed renal cortical scarring in all patients. 7) Voiding cystourethrographic findings in 38 patients showed vesicoureteral reflux in 13 patients. 8) We performed urine culture again after 48 hours from the beginning of therapy and 85.5% of the cases became sterile. 9) The recurrent percentage of UTI was 23.8% with the ratio of 1:1.5 between male and female. Most of the patients were children under the age of one year. 10) Operations were made on two cases showing the increase of reflux during the follow-up of unilateral Grade Ⅱ and GradeⅢ reflux, respectively. Operations were also performed on other two cases with bilateral GradeⅣ reflux. All the cases were good after the operations. In the meantime, as for another two cases having the raght reflux of Grade Ⅱ and the bilateral reflux of Grade Ⅲ, the refluxes were able to be reduced by prophylaxis only, in the course of following up.

Keywords :Symptomatic urinary tract infection