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Kinder- und Jugendmedizin 2008; 08(04): 223-231
DOI: 10.1055/s-0038-1630487
Aus der Praxis für die Praxis
Schattauer GmbH

Harnwegsinfektionen im Kindesalter

Diagnostik und TherapieThe child with urinary tract infectionDiagnostic investigation and treatment
Marcus R. Benz
1   Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, München (Direktor: Prof. Dr. med. D. Reinhardt)
,
Lutz T. Weber
1   Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital, München (Direktor: Prof. Dr. med. D. Reinhardt)
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Eingegangen: 23. Oktober 2007

angenommen: 15. Januar 2008

Publikationsdatum:
25. Januar 2018 (online)

    Lizenzen und Reprints

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.
    CrossrefPubMedGoogle Scholar
  • 2 American Academy of Pediatrics.. Circumcision policy statement. Pediatrics 1999; 103: 686-693.
    CrossrefPubMedGoogle Scholar
  • 3 Bachur R. Nonresponders: prolonged fever among infants with urinary tract infections. Pediatrics 2000; 105: 1147.
    Google Scholar
  • 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.
    CrossrefGoogle Scholar
  • 5 Benz MR, Stehr M, Kammer B. et al. Foreign body in the bladder mimicking nephritis. Pediatr Nephrol 2007; 22 (Suppl. 03) 467-470.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 7 Dick P, Feldmann W. Routine diagnostic imaging for childhood urinary tract infections: a systematic overview. J pediatr 1996; 128: 15-22.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 10 Jodal U, Hansson S. Harnwegsinfektionen. In: Schärer K, Mehls O. (Hrsg). Pädiatrische Nephrologie. Berlin, Heidelberg, New York: Springer; 2002: 269-287.
    CrossrefGoogle Scholar
  • 11 Kontiokari T, Nuutinen M, Uhari M. Dietary factors affecting susceptibility to urinary tract infection. Pediatr Nephrol 2004; 19: 378-383.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 13 Kumer RK, Turner GM, Coulthard MG. Don’t count on urinary white cells to diagnose childhood urinary tract infection. BMJ 1996; 312: 1359.
    Google Scholar
  • 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.
    Google Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 18 Ramage IJ, Chapman JP, Hollman AS. et al. Accuracy of clean-catch urine collection in infancy. J Pediatr 1999; 135: 765-767.
    CrossrefPubMedGoogle Scholar
  • 19 Schmitt CP. Keimspekrum und Resistenzlage bei Harnwegsinfektionen im Kindesalter. Monatsschr Kinderheilkd 2007; 155: 228-233.
    CrossrefGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 23 Tönshoff B, Beetz R. Antibiotische Dauerprophylaxe bei Harnwegsinfektionen. Wann, womit, wie lange?. Monatsschr Kinderheilkd 2007; 155: 242-251.
    CrossrefGoogle Scholar
  • 24 Turner GM, Coulthard MG. Fever can cause pyuria in children. BMJ 1995; 311: 924.
    CrossrefPubMedGoogle Scholar
  • 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.
    PubMedGoogle Scholar
  • 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.
    CrossrefPubMedGoogle Scholar
  • 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.
    Google Scholar
  • 28 Wiswell TE. The prepuce, urinary tract infections, and the consequences. Pediatrics 2000; 105: 860-864.
    CrossrefPubMedGoogle Scholar