基层医疗卫生机构常见新生儿疾病诊疗专家共识:新生儿泌尿系感染(2025年)

中华医学会儿科学分会新生儿学组;《中国当代儿科杂志》编辑委员会

中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (9) : 1038-1044.

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中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (9) : 1038-1044. DOI: 10.7499/j.issn.1008-8830.2412183
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基层医疗卫生机构常见新生儿疾病诊疗专家共识:新生儿泌尿系感染(2025年)

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Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal urinary tract infection (2025)

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文章历史 +

摘要

为了有效帮助基层医护工作者及时识别新生儿泌尿系感染,早期诊断,早期治疗,减少漏诊,改善预后,中华医学会儿科学分会新生儿学组和《中国当代儿科杂志》编辑委员会组织专家整合了最新的新生儿泌尿系感染临床研究进展,通过充分讨论,制定了《基层医疗卫生机构常见新生儿疾病诊疗专家共识:新生儿泌尿系感染(2025年)》。该共识针对基层医护人员对于新生儿泌尿系感染的10个常见临床问题,形成了17条推荐意见。

Abstract

To effectively assist primary healthcare providers in timely identification, early diagnosis, and early treatment of neonatal urinary tract infections (UTIs), thereby reducing missed diagnoses and improving outcomes, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association and the Editorial Board of Chinese Journal of Contemporary Pediatrics organized experts to integrate the latest clinical research progress on neonatal UTIs. Following comprehensive discussions, the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal urinary tract infection (2025)" was developed. This consensus covers 10 common clinical issues faced by primary healthcare providers regarding neonatal UTIs and formulates 17 recommendations.

关键词

泌尿系感染 / 诊断 / 治疗 / 共识 / 基层医疗卫生机构 / 新生儿

Key words

Urinary tract infection / Diagnosis / Treatment / Consensus / Primary healthcare institution / Neonate

引用本文

导出引用
中华医学会儿科学分会新生儿学组;《中国当代儿科杂志》编辑委员会. 基层医疗卫生机构常见新生儿疾病诊疗专家共识:新生儿泌尿系感染(2025年)[J]. 中国当代儿科杂志. 2025, 27(9): 1038-1044 https://doi.org/10.7499/j.issn.1008-8830.2412183
Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association; Editorial Board of Chinese Journal of Contemporary Pediatrics. Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal urinary tract infection (2025)[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(9): 1038-1044 https://doi.org/10.7499/j.issn.1008-8830.2412183

参考文献

[1]
't Hoen LA, Bogaert G, Radmayr C, et al. Update of the EAU/ESPU guidelines on urinary tract infections in children[J]. J Pediatr Urol, 2021, 17(2): 200-207. DOI: 10.1016/j.jpurol.2021.01.037 .
[2]
Ladomenou F, Bitsori M, Galanakis E. Incidence and morbidity of urinary tract infection in a prospective cohort of children[J]. Acta Paediatr, 2015, 104(7): e324-e329. DOI: 10.1111/apa.12992 .
[3]
Shaikh N, Haralam MA, Kurs-Lasky M, et al. Association of renal scarring with number of febrile urinary tract infections in children[J]. JAMA Pediatr, 2019, 173(10): 949-952. PMCID: PMC6686976. DOI: 10.1001/jamapediatrics.2019.2504 .
[4]
Chou HH, Huang LC, Shen SP, et al. Neonatal jaundice is associated with increased risks of congenital anomalies of the kidney and urinary tract and concomitant urinary tract infection[J]. Sci Rep, 2024, 14(1): 9520. PMCID: PMC11045864. DOI: 10.1038/s41598-024-59943-2 .
[5]
Drumm CM, Siddiqui JN, Desale S, et al. Urinary tract infection is common in VLBW infants[J]. J Perinatol, 2019, 39(1): 80-85. DOI: 10.1038/s41372-018-0226-4 .
[6]
Abda A, Panetta L, Blackburn J, et al. Urinary tract infections in very premature neonates: the definition dilemma[J]. J Perinatol, 2024, 44(5): 731-738. DOI: 10.1038/s41372-024-01951-1 .
[7]
Hernández-Bou S, Trenchs V, Cano I, et al. Neonates with urinary tract infection: is a lumbar puncture always indicated?[J]. Pediatr Infect Dis J, 2020, 39(9): 849-853. DOI: 10.1097/INF.0000000000002683 .
[8]
Lo YC, Tsai WJ, Tsao PC, et al. Relationship between infectious screening and early unconjugated hyperbilirubinemia in well-appearing neonates[J]. J Chin Med Assoc, 2020, 83(4): 406-410. DOI: 10.1097/JCMA.0000000000000290 .
[9]
Ferreira ICDS, Menezes RP, Jesus TA, et al. Unraveling the epidemiology of urinary tract infections in neonates: perspective from a Brazilian NICU[J]. Am J Infect Control, 2024, 52(8): 925-933. DOI: 10.1016/j.ajic.2024.03.009 .
[10]
Washahi M, Miron D, Steinberg Ben Zeev Z, et al. High rates of ESBL-producing and gentamycin-resistant gram-negative bacteria during the first week of life: a multicenter cross-sectional study among infants younger than 2 months with urinary tract infection[J]. Pediatr Infect Dis J, 2023, 42(9): 750-753. DOI: 10.1097/INF.0000000000003977 .
[11]
Strohmeier Y, Hodson EM, Willis NS, et al. Antibiotics for acute pyelonephritis in children[J]. Cochrane Database Syst Rev, 2014, 2014(7): CD003772. PMCID: PMC10580126. DOI: 10.1002/14651858.CD003772.pub4 .
[12]
Subcommittee on Urinary Tract Infection. Reaffirmation of AAP clinical practice guideline: the diagnosis and management of the initial urinary tract infection in febrile infants and young children 2-24 months of age[J]. Pediatrics, 2016, 138(6): e20163026. DOI: 10.1542/peds.2016-3026 .
[13]
Kilpatrick R, Boutzoukas AE, Chan E, et al. Urinary tract infection epidemiology in NICUs in the United States[J]. Am J Perinatol, 2024, 41(S 01): e2202-e2208. PMCID: PMC11326515. DOI: 10.1055/s-0043-1771015 .
[14]
Hong L, Huang Y, Han J, et al. Pathogen-specific alterations in intestinal microbiota precede urinary tract infections in preterm infants: a longitudinal case-control study[J]. Gut Microbes, 2024, 16(1): 2333413. PMCID: PMC10986765. DOI: 10.1080/19490976.2024.2333413 .
[15]
Shaikh N, Shope TR, Hoberman A, et al. Association between uropathogen and pyuria[J]. Pediatrics, 2016, 138(1): e20160087. DOI: 10.1542/peds.2016-0087 .
[16]
Herreros ML, Gili P, Del Valle R, et al. Urine collection methods for infants under 3 months of age in clinical practice[J]. Pediatr Nephrol, 2021, 36(12): 3899-3904. DOI: 10.1007/s00467-021-05142-4 .
[17]
Kocaaslan R, Dilli D, Çitli R. Diagnostic value of the systemic immune-inflammation index in newborns with urinary tract infection[J]. Am J Perinatol, 2024, 41(S 01): e719-e727. DOI: 10.1055/s-0042-1757353 .
[18]
Kim HW, Hwang J, Pai KS, et al. Urinary tract dilation classification system for predicting surgical management and urinary tract infection in neonates and young infants: a systematic review and meta-analysis[J]. Pediatr Radiol, 2024, 54(5): 795-804. DOI: 10.1007/s00247-024-05854-3 .
[19]
Selmi I, Azzabi O, Khlayfia Z, et al. Urinary tract infection in the neonates: what radiologic investigations should we do?[J]. Tunis Med, 2020, 98(12): 1005-1010.
[20]
Kauffman JD, Danielson PD, Chandler NM. Risk factors and associated morbidity of urinary tract infections in pediatric surgical patients: a NSQIP pediatric analysis[J]. J Pediatr Surg, 2020, 55(4): 715-720. DOI: 10.1016/j.jpedsurg.2019.04.030 .
[21]
中华医学会儿科学分会肾脏学组. 泌尿道感染诊治循证指南(2016)[J]. 中华儿科杂志, 2017, 55(12): 898-901. DOI: 10.3760/cma.j.issn.0578-1310.2017.12.005 .
[22]
沈茜. 儿童泌尿道感染诊治规范[J]. 中华实用儿科临床杂志, 2021, 36(5): 337-341. DOI: 10.3760/cma.j.cn101070-20210127-00115 .
[23]
Krasity B, Hasan M, Uppuluri S, et al. Standardization of urinary tract infection diagnosis in the neonatal ICU: experience at a tertiary care center[J]. J Neonatal Perinatal Med, 2024, 17(1): 13-20. DOI: 10.3233/NPM-230101 .
[24]
中国医疗保健国际交流促进会临床微生物学分会. 靶向高通量测序在感染性疾病中应用与实践专家共识[J]. 中华医学杂志, 2024, 104(48): 4375-4383. DOI: 10.3760/cma.j.cn112137-20240927-02208 .
[25]
Simões e Silva AC, Oliveira EA. Update on the approach of urinary tract infection in childhood[J]. J Pediatr (Rio J), 2015, 91(6 ): S2-S10. DOI: 10.1016/j.jped.2015.05.003 .
Suppl 1
[26]
Shaikh N, Mattoo TK, Keren R, et al. Early antibiotic treatment for pediatric febrile urinary tract infection and renal scarring[J]. JAMA Pediatr, 2016, 170(9): 848-854. DOI: 10.1001/jamapediatrics.2016.1181 .
[27]
Leung AKC, Wong AHC, Leung AAM, et al. Urinary tract infection in children[J]. Recent Pat Inflamm Allergy Drug Discov, 2019, 13(1): 2-18. PMCID: PMC6751349. DOI: 10.2174/1872213X13666181228154940 .
[28]
廖毅, 刘兴楼. 儿童泌尿系统感染的抗菌药物的选择与使用策略[J]. 中华儿科杂志, 2022, 60(9): 964-966. DOI: 10.3760/cma.j.cn112140-20220702-00611 .
[29]
Desai S, Aronson PL, Shabanova V, et al. Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections[J]. Pediatrics, 2019, 144(3): e20183844. PMCID: PMC6855812. DOI: 10.1542/peds.2018-3844 .
[30]
中华医学会儿科学分会新生儿学组, 中华儿科杂志编辑委员会. 新生儿败血症诊断与治疗专家共识(2024)[J]. 中华儿科杂志, 2024, 62(10): 931-940. DOI: 10.3760/cma.j.cn112140-20240505-00307 .
[31]
Janardhan S, Kim S, Cukovic B, et al. Urinary tract infections in low birth weight neonates[J]. Am J Perinatol, 2024, 41(S 01): e775-e779. DOI: 10.1055/s-0042-1757454 .
[32]
Yelin I, Snitser O, Novich G, et al. Personal clinical history predicts antibiotic resistance of urinary tract infections[J]. Nat Med, 2019, 25(7): 1143-1152. PMCID: PMC6962525. DOI: 10.1038/s41591-019-0503-6 .
[33]
Robinson JL, Le Saux N. Management of urinary tract infections in children in an era of increasing antimicrobial resistance[J]. Expert Rev Anti Infect Ther, 2016, 14(9): 809-816. DOI: 10.1080/14787210.2016.1206816 .
[34]
Stein R, Dogan HS, Hoebeke P, et al. Urinary tract infections in children: EAU/ESPU guidelines[J]. Eur Urol, 2015, 67(3): 546-558. DOI: 10.1016/j.eururo.2014.11.007 .
[35]
NICE. Urinary tract infection in under 16s: diagnosis and management[EB/OL]. (2022-07-27)[2024-08-08].
[36]
Hikmat S, Lawrence J, Gwee A. Short intravenous antibiotic courses for urinary infections in young infants: a systematic review[J]. Pediatrics, 2022, 149(2): e2021052466. DOI: 10.1542/peds.2021-052466 .
[37]
Goldberg L, Borovitz Y, Sokolover N, et al. Long-term follow-up of premature infants with urinary tract infection[J]. Eur J Pediatr, 2021, 180(9): 3059-3066. DOI: 10.1007/s00431-021-04131-x .

脚注

所有专家均声明无利益冲突。

基金

科技部国家重点研究发展计划(2022YFC2704805)

编委: 邓芳明

版权

版权所有 © 2023中国当代儿科杂志
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