Harnwegsinfektionen im Kindesalter

Zusammenfassung

Harnwegsinfektionen gehören zu den häufigsten bakteriellen Infektionserkrankungen im Kindesalter. Neben der akuten Morbidität können sie Indikator für assoziierte Fehlbildungen der Nieren und der ableitenden Harnwege oder Blasenentleerungsstörungen sein und führen bedingt durch Nierenparenchymschädigung in einigen Fällen zu signifikanten Spätkomplikationen wie arterieller Hypertonie oder chronischer Niereninsuffizienz. Die frühzeitige Sicherung der Diagnose, die rasche, kalkulierte antibakterielle Therapie und die Einleitung adäquater uroradiologischer Diagnostik sind entscheidend für die Prognose. Da Harnwegsinfektionen zur Rekurrenz neigen, kommt der Prophylaxe weiterer Harnwegsinfektionen nach akuter Therapie und abgeschlossener Diagnostik eine große Bedeutung zu.

Summary

Urinary tract infection in childhood is a significant and common problem. Urinary tract infection is a cause of acute illness, sometimes an indicator of underlying abnormality of the urinary tract or bladder dysfunction, and can be associated with significant long-term sequelae like hypertension or chronic renal failure due to renal scarring. Early diagnosis, efficient treatment, and adequate uroradiologic investigation is most important for prognosis. Since urinary tract infections are often recurrent, finding a suitable kind of prophylaxis is crucial.

Schlüsselwörter

Harnwegsinfektion - Pyelonephritis

Keywords

Urinary tract infection - pyelonephritis

• Literatur

• 1 American Academy of Pediatrics.. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 1999; 103 (Suppl. 04) 843-852.
• 2 American Academy of Pediatrics.. Circumcision policy statement. Pediatrics 1999; 103: 686-693.
• 3 Bachur R. Nonresponders: prolonged fever among infants with urinary tract infections. Pediatrics 2000; 105: 1147.
• 4 Beetz R, Bachmann H, Gatermann S. et al. Harnwegsinfektionen im Säuglings- und Kindesalter – Konsensusempfehlungen zu Diagostik, Therapie und Prophylaxe. Monatsschr Kinderheilkd 2007; 155: 261-271.
• 5 Benz MR, Stehr M, Kammer B. et al. Foreign body in the bladder mimicking nephritis. Pediatr Nephrol 2007; 22 (Suppl. 03) 467-470.
• 6 Craig CJ, Knight JF, Sureshkumar P. et al. Effect of circumcision on incidence of urinary tract infection in preschool boys. J Pediatr 1996; 128: 23-27.
• 7 Dick P, Feldmann W. Routine diagnostic imaging for childhood urinary tract infections: a systematic overview. J pediatr 1996; 128: 15-22.
• 8 Downs SM. Technical report: Urinary tract infections in febrile infants and young children. The urinary tract subcommittee of the American Academy of Pediatrics committee on quality improvement. Pediatrics 1999; 103: e54.
• 9 Fuenfstueck R, Straube E, Schildbach O, Tietz U. Prevention of reinfection by L-methionine in patients with recurrent urinary tract infection. Med Klin 1997; 92 (Suppl. 10) 574-581.
• 10 Jodal U, Hansson S. Harnwegsinfektionen. In: Schärer K, Mehls O. (Hrsg). Pädiatrische Nephrologie. Berlin, Heidelberg, New York: Springer; 2002: 269-287.
• 11 Kontiokari T, Nuutinen M, Uhari M. Dietary factors affecting susceptibility to urinary tract infection. Pediatr Nephrol 2004; 19: 378-383.
• 12 Kontiokari T, Sundqvist K, Nuutinin M. et al. Randomised trial of cranberry-lingonberry juice and Lactobacillus GG drink for prevention of urinary tract infection in women. BMJ 2001; 322: 1571-1573.
• 13 Kumer RK, Turner GM, Coulthard MG. Don’t count on urinary white cells to diagnose childhood urinary tract infection. BMJ 1996; 312: 1359.
• 14 Lambert H, Coulthard M. The child with urinary tract infection. In: Webb N, Postlethwaite R. (eds). Clinical paediatric nephrology. 3 ed. Oxford University Press; 2003: 197-226.
• 15 Liaw LCT, Nayar DM, Pedler SJ. et al. Home collection of urine for culture from infants by three methods: survey of parents’ preferences and bacterial contaminations rates. BMJ 2000; 320: 1312-1313.
• 16 Loening-Bauche V. Urinary incontinence and uri-nary tract infection and their resolution with treatment of chronic constipation in childhood. Pediatrics 1997; 100: 228-232.
• 17 Marild S, Jodal U. Incidence of first-time symptomatic urinary tract infection in children under 6 years of age. Acta Paediatr 1998; 87: 549-552.
• 18 Ramage IJ, Chapman JP, Hollman AS. et al. Accuracy of clean-catch urine collection in infancy. J Pediatr 1999; 135: 765-767.
• 19 Schmitt CP. Keimspekrum und Resistenzlage bei Harnwegsinfektionen im Kindesalter. Monatsschr Kinderheilkd 2007; 155: 228-233.
• 20 Schoen E, Colby C, Ray G. Newborn circumcision decreases incidence and costs of urinary tract infections during the first year of life. Pediatrics 2000; 105: 789-793.
• 21 Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Arch Dis Child. 2005; 90 (Suppl. 08) 853-858.
• 22 Smellie J, Poulton A, Prescod N. Retrospective study of children with renal scarring associated with reflux and urinary tract infection. BMJ 1994; 308: 1193-1196.
• 23 Tönshoff B, Beetz R. Antibiotische Dauerprophylaxe bei Harnwegsinfektionen. Wann, womit, wie lange?. Monatsschr Kinderheilkd 2007; 155: 242-251.
• 24 Turner GM, Coulthard MG. Fever can cause pyuria in children. BMJ 1995; 311: 924.
• 25 Vernon S, Foo CK, Coulthard MG. How general practitioners manage children with urinary tract infection: an audit in the former Nothern Region. Br J Gen Pract 1997; 47: 297-300.
• 26 Wiliams G, Lee A, Craig JC. Antibiotics for prevention of urinary tract infection in children: a systematic review of randomised controlled trials. J Pediatr 2001; 138: 868-874.
• 27 Wiliams G, Wei L, Lee A. et al. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev 2006; 3: CD001534.
• 28 Wiswell TE. The prepuce, urinary tract infections, and the consequences. Pediatrics 2000; 105: 860-864.