the age-related risk of co-existing meningitis in children with urinary tract infection与年龄相关的风险与尿路感染儿童脑膜炎共存的.pdf

The Age-Related Risk of Co-Existing Meningitis in Children with Urinary Tract Infection 1,2,3 2 3,4 4 1,2,3 Marc Tebruegge *, Anastasia Pantazidou , Vanessa Clifford , Gena Gonis , Nicole Ritz , Tom Connell1,2,3, Nigel Curtis1,2,3 1 Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia, 2 Infectious Diseases Unit, Department of General Medicine, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia, 3 Murdoch Children’s Research Institute, Parkville, Victoria, Australia, 4 Department of Microbiology, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia Abstract Objective: The primary aim of this study was to determine age-stratified rates of co-existing bacterial meningitis in children with urinary tract infection (UTI). The secondary aims of this study were to determine the causative pathogens of UTI, and the clinical features and outcome of children with co-existing meningitis. Methods: Analysis of data collected over a nine-year period at a tertiary pediatric hospital in Australia. Study population: children below 16 years of age with culture-confirmed UTI and a paired CSF sample. Results: A total of 748 episodes in 735 cases were included in the final analysis. The commonest pathogens causing UTI were Escherichia coli (67.4%), Enterococcus faecalis (8.4%), Klebsiella oxytoca (3.5%) and Klebsiella pneumoniae (3.5%). Only two (1.2%; 95% CI: 0.15–4.36%) of 163 neonates (between 0 and 28 days of age) with UTI had co-existing meningitis. Both presented with pyrexia, irritability and lethargy, and recovered uneventfully with antibiotic treatment. There were no cases of co-existing meningitis among 499 infants