关键词: 泌尿道感染, 儿童, 惊厥, 病原菌, 药敏试验, 炎症

Abstract: Background　Urinary tract infections（UTIs） are common in children，mostly caused by Escherichia coli. Some children with UTIs may have convulsion，which aggravates the condition and prolongs the treatment time. However，there have been no studies comparing inflammatory indicators and pathogenic bacteria between UTIs children with and without convulsion. Objective　To perform a comparative analysis of inflammatory indicators，common pathogenic bacteria and antibiotic resistance between UTIs children with and without convulsion，providing evidence for clinical treatment. Methods　We enrolled 181 children with UTIs from Wuxi Children's Hospital during 2010 to 2019，including 81 with convulsion（convulsive group），and 100 without （non-convulsive group） . Data about sex，age，results of routine blood test （WBC，CRP，PCT），urine culture test and sensitivity test of two groups were collected. Results　Convulsive group had higher average PCT level （P<0.05）. Forty species of pathogenic bacteria（49.4%） were isolated from the samples of convulsive cases，47.5% of which（19/40） were gram-negative bacteria，and 52.5%（21/40） were gram-positive bacteria. Twenty-seven species of pathogenic bacteria（27.0%） were isolated from the samples of non-convulsive cases，85.2% of which（23/27） were gram-negative bacteria，and 14.8%（4/27） were gram-positive bacteria. No fungus was isolated from samples of both groups. Escherichia coli was the most common bacterium infected in both groups. The difference in the prevalence of infected Escherichia coli and non-Escherichia coli between the two groups was statistically significant （P < 0.05）. Escherichia coli had a high resistance rate to ampicillin（93.3%），cefazolin（86.7%） and ceftriaxone（73.3%），and a low resistance rate to imipenem（0），cefotetan（0），ertapenem（0）. Enterococcus faecium had a high resistance rate above 80.0% to ampicillin（92.3%），clindamycin（100.0%），erythromycin（84.6%），and penicillin G（92.3%），and a low resistance rate to vancomycin（0），linezolid（0） and nitrofurantoin（23.1%）. Conclusion　For children with UTIs，attentions should be given to the detection of PCT and timely assessment of infection level，to guide clinical treatment of controlling infection，and reducing the risk of convulsion promptly. For those also with convulsion，clinical focus should be given to midstream urine culture and sensitivity test，and appropriate selection of effective antibiotics to control the disease progression in time.

Key words: Urinary tract infections, Child, Convulsions, Pathogenic bacteria, Drug sensitive test, Inflammation