Articole semnate de acelasi autor in Revista Romana de Pediatrie:

ASPECTE CLINICO-EVOLUTIVE ALE INFECTIEI URINARE LA PREMATUR

Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 1, An 2014

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Magdalena I. Starcea, Mihaela Munteanu, Radu V. Russu, Ovidiu Brumariu, Delia Andreia Bizim and Ingrith C. Miron

REZUMAT

Obiectiv. Studiul îşi propune analiza comparativă a cazurilor de ITU la copii 0-3 ani (prematuri şi născuţi la termen) internaţi în Clinica IV Pediatrie Iaşi, între ian. 2007 – dec. 2011. Material şi metodă. Am efectuat un studiu retrospectiv pe un lot de 298 de copii între 0-3 ani, internaţi cu infecţie de tract urinar (ITU). Au fost urmărite particularităţile ITU la prematur în funcţie de gradul prematurităţii, etiologia ITU, comorbidităţi, aspecte evolutive, responsivitate la tratament şi impactul ITU asupra rinichiului. Rezultate. Lotul de studiu a fost alcătuit împărţit în copii născuţi la termen şi copii născuţi prematur, la vârstă gestaţională mai mică de 37 săptămâni, cu greutatea mai mică de 2.500 g. Riscul ITU la prematur este influenţat de vârstă, fiind de 3 ori mai mare la nou născutul prematur faţă de copilul 1-3 ani. Vârsta medie a fost de 8,8 luni la prematuri şi 14,09 luni la născuţii la termen. Cei mai mulţi copii s-au încadrat în gradul LBW. Etiologia infecţiei urinare a fost dominată la ambele subloturi de Escherichia coli, Proteus mirabilis şi Klebsiella pneumoniae. La prematuri, bacteriile oportuniste (bacil Piocianic, Enterococ, Acinetobacter) determină 16% din ITU, faţă de doar 2% la copii născuţi la termen. Febra a fost semnul clinic dominant la toţi pacienţii. În ordinea frecvenţei, celelalte semne prezente la prematuri au fost inapetenţa, icter prelungit, diaree, detresă respiratorie. Debutul prin insuficienţă renală acută s-a înregistrat la 12,5% dintre prematuri şi doar 1% dintre copii născuţi la termen. Tratamentul antibiotic iniţiat empiric a fost eficient la majoritatea cazurilor. Cel mai frecvent implicate în rezistenţa microbiană au fost aminopenicilinele, Trimetoprim-Sulfmetoxazolul şi Cefalosporine. Concluzii. Diagnosticul prompt şi tratamentul adaptat au un rol important în reducerea morbidităţii infecţioase, a riscului de cicatrici renale şi a reabilitării nutriţionale rapide a prematurului.

Cuvinte cheie: infecţie urinară, prematuritate, anomalii congenitale renale, copii 0-3 ani

Full text | PDF

Magdalena I. Starcea

CLINICAL ASPECTS AND EVOLUTION OF URINARY TRACT INFECTION IN PRETERM INFANTS

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Magdalena I. Starcea, Mihaela Munteanu, Radu V. Russu, Ovidiu Brumariu, Delia Andreia Bizim and Ingrith C. Miron

ABSTRACT

Objective. The aim of the study is a comparative analysis of cases of UTI in children 0-3 years (preterm and term infants) admitted to the IVth Pediatric Clinic , “Sf. Maria” Emergency Hospital for Children, Iasi, between January 2007 – December 2011.

Material and methods. We performed a retrospective study on a group of 298 children, age 0-3 years, hospitalized with urinary tract infection (UTI). We identified the features of preterm infants with UTI according to the degree of prematurity, UTI etiology, comorbidities, developmental issues, responsiveness to treatment, and impact of UTI on kidney.

Results. The study group was divided into term and preterm children (defined as gestational age less than 37 weeks, weighing less than 2500g). Preterm UTI risk was influenced by age, being 3 times higher compared with children aged 1-3 years. The average age of UTI was 8.8 months for preterms and 14.09 months for term babies. Most preterm children were classified in LBW category. The etiology of urinary infection was dominated in both subgroups by E. coli, Proteus mirabilis and Klebsiella pneumoniae. In preterm children, opportunistic bacteria (bacillus Pseudomonas, enterococci, Acinetobacter) determined 16% of UTIs, compared to only 2% in term children. Fever was the dominant clinical sign in all patients. Other signs on preterms were loss of appetite, prolonged jaundice, diarrhea, respiratory distress. The onset of acute renal failure occurred in 12.5% of preterm and only 1% of term children. First line antibiotherapy was effective in most cases. In microbial resistance, the most frequently involved were aminopenicillins, Sulfamethoxazole-Trimethoprim and cephalosporins.

Conclusions. The early diagnosis and treatment have an important role in reducing infectious morbidity, the risk of renal scarring and rapid nutritional rehabilitation in preterm infants.

Keywords: urinary tract infection, preterm infant, CAKUT, E.coli

Full text | PDF

Magdalena I. Starcea