Clinical Analysis Of Congenital Abnormalities Of The Kidmey And Urinary Tract Complicated With Urinary Tract Infection In Hospitalized Children In Single Center

Objective:Through retrospective analysis of the clinical data of children with CAKUT in the past 5 years,the risk factors of CAKUT complicated with urinary tract infection are summarized,and clinical experience is accumulated,with a view to early identification of high-risk children with CAKUT susceptible to urinary tract infection and reduce the risk of CAKUT complicated with urinary tract infection.The recurrence of children with tract infections,and at the same time provide suggestions and help for clinical prevention of urinary tract infections in children with CAKUT.Method:Select the case data of CAKUT diagnosed in Jiangxi Provincial Children’s Hospital from October 1,2015 to September 31,2020 and were hospitalized.The 323children who met the inclusion criteria(169 cases with urinary tract infection,no combined 154 cases of urinary tract infection)were retrospectively analyzed;basic information,clinical manifestations,examination results,treatment plans and other data were collected,and multi-factor analysis of the risk factors for urinary tract infection in children with CAKUT was performed.Results:The rate of urinary tract infection in children with CAKUT is 52.3%,CAKUT with urinary tract infection and children without urinary tract infection were found to be differencel in age distribution(χ~2=64.594,P<0.05),and whether the mother was abnormal during pregnancy(χ~2=22.718,P<0.00),white blood cells(χ~2=34.361,P<0.05),platelets(χ~2=5.071,P<0.05),anemia(χ~2=23.083,P<0.05),whether to undergo surgery(χ~2=16.561,P<0.00),there was a statistically significant difference in the number of days of hospitalization,and there was no statistically significant difference in the gender(χ~2=0.127,P<0.05),red blood cell(χ~2=64.594,P>0.05)and the severity of admission to the hospital.Urine specimens of the children were cultured,and 120 pathogens were detected.Among them,Escherichia coli was the most common among gram-negative bacteria.The drug sensitivity results showed that the most sensitive drugs were amikacin and imipenem.And piperacillin and tazobactam,the drugs with the highest resistance rate are ampicillin,piperacillin,cefazolin and cefotaxime.Among gram-positive bacteria,Enterococcus faecium is the most common.The drug sensitivity results show that the most sensitive drugs are teicoplanin,vancomycin and linezolid.The drugs with the highest resistance rate are erythromycin and compound new.Normin,clindamycin and trimethoprim.A multivariate unconditional Logistic regression analysis of the risk factors that lead to urinary tract infections in children with CAKUT showed that compared with children with CAKUT in adolescence,children with CAKUT in infancy have a greater risk of urinary tract infection(OR=5.585);CAKUT increased the number of days in hospital,and the risk of combined urinary tract infection increased(OR=1.281);when the white blood cell count was high at admission,the risk of combined urinary tract infection increased(OR=1.222).While receiving surgical treatment(OR=0.028)and age in the neonatal period(OR=0.006)were protective factors.Conclusion:CAKUT is often found through urinary tract ultrasound screening.It is more common in men and infants.Children with CAKUT have a higher rate of urinary tract infection.Therefore,children with urinary tract infection should routinely improve urinary tract ultrasound excretion CAKUT.Age in infants and high white blood cell counts at first diagnosis are risk factors for urinary tract infections in children with CAKUT,and surgical treatment is a protective factor.Therefore,care should be taken to prevent urinary tract infections for children with CAKUT in infants and young children,and active treatment should be taken when they are combined with other system infections,and children who meet the conditions for surgery should be operated in time.