Urinary Tract Infections In Childhood

Abstract

Abstract

One of the most common causes of childhood infections is urinary tract infecti-on (UTI). Permanent renal damage is seen in 15% of patients and hypertension, proteinuria or chronic renal disease are among the long-term sequelae of UTI. Escherichia coliis the most important bacterial cause of UTI, and responsible for 70-80%of infections. The development and severity of the disease is related to multiple factors such as bacterial virulence, immune system, the presence of urinary obstruction, bladder and bowel dysfunctions, vesicoureteral reflux, and bladder catheterizations. In urinary tract infection, the diagnosis is made by physical examination of thepatient, complete urine analysis and urine culture. Early and effective antibiotic treatment is important to prevent renal damage. The antibiotic selection depends on patient age, underlying medical and urological problems, and antibiotic resistance in that area. The goal for further investigation is to find outwhether there is a urinary obstruction, vesicoureteral reflux or renal damage. Ultrasonography can identify abnormalities in the upper and lower urinary system. Renal scintigraphy is useful for the detection of renal parenchymaldamage, and voiding cystourethrography is used for detection of vesicoureteral reflux. Multidisciplinary workupincluding pediatrician, pediatric nephrologist and urolo-gist is important in the follow-up of children who require further investigation.

Keywords

• Urinary tract infection,vesi-coureteral reflux,pyeloneph-ritis,children

Çocuklarda İdrar Yolu Enfeksiyonu

Öz

Öz

Çocukluk çağı enfeksiyonlarının en sık nedenlerinden biri idrar yolu enfeksiyonudur (İYE). Kalıcı böbrek hasarı hastaların %15’inde görülür ve hipertansiyon, pro-teinüri veya kronik böbrek hastalığı uzun dönem sekelleridir. Escherichia coliİ YE’ninen önemli bakteriyel sebebi olup, enfeksiyonların %70-80’inden sorumludur. İYE mgelişiminde ve hastalığın şiddetinde bakteriyel virulans faktörleri, konağın bağışıklık sistemi, üriner obstrüksiyon varlığı, mesane ve barsak disfonksiyonları, vezikoüretral reflü ve mesane kateterizasyonları etkilidir.İdrar yolu enfeksiyonunda tanı, hastanın fizik muayene bulguları, tam idrar tahlili ve idrar kültürü ile konur. Renal hasarı önlemede erken ve etkili antibiyotik başlanması önemlidir. Antibiyotik seçimini, hasta yaşı, altta yatan medikal ve ürolojik problemler ve o bölgedeki antibiyotik direnci etkiler. İdrar yolu enfeksiyonu geçiren çocukta incelemenin amacı varsa obstrüksiyonu, reflüyü ve hasarı ortaya koymaktır. Üst ve alt üriner sistemdeki anomalileri göstermede ultrasonografi, renal parankim hasarını saptamada renal sintigrafi, vezikoüreteral reflünün ortaya konmasında voiding sistoüreterografi kullanılır. İleri inceleme gerektiren çocukların izleminde pediatrist, pediatrik nefrolog ve ürolog iş birliği önemlidir.

Anahtar Kelimeler

• İdrar yolu enfeksiyonu,vezikoü-reteral reflü,piyelonefrit,çocuk

References

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