Clinical, Subclinical Characteristics and Classify Urinary Tract Malformation in Children with Urinary Tract Infections at the National Children’s Hospital

Pham Van Dem, Vu Thi Ngoc Bich, Luong Thi Phuong, Nguyen Thu Huong
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Abstract

Aim: To describe clinical, subclinical characteristics and classify urinary tract malformation in children with urinary tract infections at the National Children’s Hospital. Subjects and research methods: A cross-sectional descriptive study on 100 children with urinary tract infections and urinary tract malformations treated at the Department of Nephrology and Dialysis of National Children’s Hospital from June 2019 to June 2021. Results: The rate of malformed urinary tract infections in children accounted for 2.1% of the total urinary tract infections. The male/female ratio was 1.22/1. The most common age was from 3 months to 3 years old (78%). The most common clinical manifestations were fever (89%) and urination disorder (52%). Symptoms of other organs included the digestive system 45%, respiratory system 24%, and nervous system 17%. Children with white blood cell count ≥15 G/L and CRP ≥ 20 mg/L accounted for 60% and 77% respectively. Kidney failure was 11% of children. There was a strong correlation between nitrite-positive and children with positive urine culture (OR: 4.7, Cl95% [1.2-15.2]). Vesicoureteral reflux was the highest observed of urinary malformation of the kidney (78%), followed by the duplex kidney (16%) and ureteropelvic junction narrowing (14%). The rates of recurrence and complications were 59% and 11%, respectively. The rate of recurrent urinary tract infections increased with the severity of reflux. Conclusion: The clinical and subclinical characteristics of urinary tract infections in urinary tract malformations children are most commonly fever, urination disorder, and vesicoureteral reflux get the highest rate.
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国立儿童医院尿路感染患儿的临床、亚临床特征及分类
目的:描述国立儿童医院尿路感染患儿的临床、亚临床特征及尿路畸形分类。对象与研究方法:对2019年6月至2021年6月在国立儿童医院肾透析科治疗的100例尿路感染和尿路畸形患儿进行横断面描述性研究。结果:儿童畸形尿路感染占总尿路感染的2.1%。男女比例为1.22/1。最常见的年龄为3个月至3岁(78%)。最常见的临床表现为发热(89%)和排尿障碍(52%)。其他器官的症状包括消化系统45%,呼吸系统24%,神经系统17%。白细胞计数≥15g /L、CRP≥20mg /L患儿分别占60%和77%。肾衰竭占儿童的11%。亚硝酸盐阳性与尿培养阳性儿童有很强的相关性(OR: 4.7, Cl95%[1.2-15.2])。膀胱输尿管反流在泌尿系肾脏畸形中发生率最高(78%),其次是双肾(16%)和输尿管肾盂连接处狭窄(14%)。复发率为59%,并发症发生率为11%。复发性尿路感染的发生率随反流的严重程度而增加。结论:尿路畸形患儿尿路感染的临床和亚临床特征以发热、排尿障碍最为常见,膀胱输尿管反流发生率最高。
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