ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ NHIỄM TRÙNG TIỂU Ở BỆNH NHI TỪ 2 THÁNG ĐẾN 16 TUỔI

Abstract

Background: urinary tract infections (UTIs) is one of popular bacterial infection in children. Timely diagnosis and treatment of urinary tract infections in children and related factors play a crucial role in minimizing complications and preventing recurrence in the future. Objective: the study aims to describe the clinical and subclinical characteristics, evaluate the treatment outcomes of UTIs in children aged 2 months to 16 years with some related factors. Materials and methods: a cross-sectional descriptive study was conducted on pediatric patients with UTIs who were examined and treated at Can Tho Children's hospital from April 2023 to April 2024. Results: a total of 52 patients were included in the study, with a male/female ratio of about 1/2, and the average age was 5.6 ± 4.2. Upper UTIs accounted for 28.8%. The predominant clinical symptoms associated with urinary tract infections in pediatric patients are frequent urination (63.5%), urine characteristics change (48.1%), fever (34.6%), dysuria (32.7%), nocturia (25.0%), respectively. Regarding laboratory characteristics, the leukocyte count was elevated, with an average of 14.2 ± 5.8, predominantly neutrophils (65.9 ± 17.2%). Urinalysis revealed erythrocytes and leukocytes in 63.5% and 48.5% of the samples respectively, yet only 7.7% tested positive for nitrites. A total of 31 cases had gram stain results, the percentage of gram negative was 74.2%. Bacterial growth was detected in 44,2% (23/52) of the urine cultures, drug-resistant pathogens account for 30.4%. The treatment success rate stood at 84.6%. Univariate analysis indicated that an elevated neutrophil count (OR = 31.5; 95%CI: 3.4-293.2; p < 0.001) and infections caused by drug-resistant pathogens (OR = 20.0; 95%CI: 1.6-248.0; p = 0.017) were associated with higher rate of treatment failure. Conclusion: urinary tract infections in children mostly involve fever and urinary disorders, a high increase in white blood cell count with a predominance of neutrophils, and relatively high appearance rate of urinary erythrocytes and leukocytes but urine nitrites (+) are rare. Most treatments are successful, but children with upper UTIs and antibiotic-resistant pathogens are associated with risk of treatment failure.