Urinary Tract Infection

Childrens hospital
:
.
:

(Pathogenesis)

UTI

Bacteria,

: ,
virus.

UTIs 3-5%, 1%
5

(toilet training)
UTIs
uncircumcised circumcision
.

UTI

Etiology

UTIs coloni bacteria.

70 90 % Escherichia coli,
Klebsiella spp.
Staphylococcus saprophyticus Enterococcus
.

Viral infection: adenovirus, cystitis



Vesicoureteric
reflux

-I : reflux

- II : reflux

pelvis colyces
(dilatation)
colyces
- III : pelvis
colyces
fornics
.
- IV :
pelvis calyces
fornics

- V :
pelvis

dipstick

Pyelonephritis

Cystitis

-Abdominal or flank pain

- (dysuria)

Asymptomatic
bacterioria
-

- (urgency)

- (frequency)

(urine)

(Nausea)
-

- Ultrasound

(suprapubic pain)

- x ray

-
(malaise)

- (incontinence)

+ (new born)

malodorous

- (poor feeding)

urine

(irritability)
-

 Pathogenesis

bacteria
bateria
Ascending infection
(mucus
(colonize)
membrane) .

uncircumcised

bacteria flora
.
bacteria (cystitis)

Hemotogenous infection

.

, ,
.

,
.
(urinalysis)
(Urine culture)

, .
-

- UTI > 5 high

.
power field
urine culture.

Ultrasonography
x ray
VCUG (voiding cystourethrography)
IVP (intravenous pyelography)

< 2

--

Cotrimoxazole

gentamycin

(4 mg trimethoprim/20mg

sulfamethoxazole /kg

12

- Gentamycin (7.5 mg/kg

(7.5 mg/kg IM
)

) + ampicilliin
IM

(50mg/kg IM/IVD 6

ampicillin, amoxicillin

cefalosporin
h

cefalexin

pyelonephritis(

E.coli,

gram negative bacilli

--
pyelonephritis


( )

Acute pyelonephritis

cystitis

- Cefalosporin aminoglycoside

-Ampicillin cotrimoxazole

20 40

nitrofurantoin
-

- quinolones

nalidixic acid acute

cefalosporins 7 10

pyelonephritis

- nalidixic acid


Nelson Text Book Of Pediatrics 18th Edition, ch 538,
pages 2223-2228.
http://haamor.com/th/ .
165



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