关键词: 泌尿道感染, 临床表现, 病原学, 婴儿, 新生

Abstract: Objective To explore the early clinical manifestations,empirical selection of antibiotics,and etiological analysis of neonatal urinary tract infection,and to summarize how to identify neonatal urinary tract infection as early as possible and how to select antibiotics reasonably in the early stage Methods The clinical data of 43 neonates diagnosed with neonatal urinary tract infection in neonatal ward of our hospital from January 2017 to October 2018 were retrospectively analyzed The main complaints,blood routine and urine routine within 24h of admission,empirical selection of antibiotics,midstream urine culture pathogen,drug susceptibility test,hospitalization time,and prognosis of neonatal urinary tract infection were collected for analysis and summary Results There were 22 cases of female children and 21 cases of male children in the study There was no significant difference in the incidence between the male and female The main clinical manifestations were jaundice(15 cases),fever(14 cases),cyanosis and abdominal distention (3 cases each) Among them,fever was more than 38 degrees in 13 cases,jaundice duration was prolonged to more than 15 days in 3 cases,or jaundice occurrence time was delayed over 7 days in 10 cases Urine culture was positive in 7 cases The blood routine and CRP and PCT indices were not uniform,but the patients with positive midstream urine culture usually had typical symptoms or positive indexes for severe infection Escherichia coli was the most common pathogen(71.4%,5/7),which was 100% sensitive to amoxicillin,clavulanate,meropenem and levofloxacin It was highly resistant to ampicillin,cefazolin and paracillin(80%) It was also resistant to common antibiotics The resistance rates to ceftriaxone and ceftazidime were 40% and 20% Conclusion The clinical manifestations of neonatal urinary tract infection are in lack of characteristics,and the main symptoms are systemic symptoms The patients with prolongation of fever and jaundice or the delayed occurrence of jaundice need to complete urinary routine and midstream urine culture as soon as possible;blood routine + CRP and PCT can not be used as diagnostic indicators of urinary tract infections,but can indicate the severity of the disease;the positive pathogens are mostly Gramnegative bacilli,mainly Escherichia coli The drug resistance rate is high.

Key words: Urinary tract infection, Clinical manifestation, Etiology, Infant,neonatal