小児感染免疫第27巻第4号

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1 C urinary tract infection UTI 2 1 UTI ,3 4 1 UTI Escherichia coli E. coli 80 5 Enterococcus 1 UTI WBCs HPF or ororor Key words JA

2 2015 小 児 感 染 免 疫 Vol. 27 No UTI UTI 7,8 6 Tc 99m DMSA dimercaptosuccinic acid 9 11 UTI 15 9,10 UTI VUR Shaikh 9,10 VUR Grade odds ratio OR 2 Grade 3 Grade 22 VUR 3 OR 2 11 CRP 4 mg dl 39E. coli DMSA 12 DMSA VUR Deflux UTI VUR renal and bladder ultrasonography RBUS voiding cystourethrography VCUG American Academy of Pediatrics AAP AAP DMSA UTI VCUG RBUS VUR VUR National institute for Health and Clinical Excellence NICE UTI 48 E. coli DMSA VCUG AAP AAP 2011 VCUG RBUS AAP VUR RBUS UTI VUR VCUG VUR 30 40VUR hyper filtration

3 AAP NICE VCUG DMSA 6 VUR AAP NICE Narchi NICE AAP Ristola AAP Ristola NICE NICE grade VUR 63 AAP grade VUR 56 VUR 36 6 VUR VCUG VUR AAP 2 24 NICE VUR GFR VUR GFR C 20 American Urological Association AUA AUA AAP2011 NICE2007 UTI UTI DMSA VCUG AAP2011 UTI VCUG Narchi AAP2011 grade VUR Ristola AAP2011 VUR 36 6 VUR VCUG 23

4 2015 小 児 感 染 免 疫 Vol. 27 No AAP2011 VCUG high grade VUR VUR VUR UTI Cheng 27 ST 28 Cheng 27 VUR 29,30 AAP 2011 DMSA VCUG AAP2011 UTI UTI UTI UTI VUR DMSA VCUG VUR UTI 1 Hoberman A, et al Prevalence of urinary tract infection in febrile infants. J Pediatr , Saadeh SA, Mattoo TK Managing urinary tract infections. Pediatr Nephrol , Marild S, Jodal U Incidence rate of first time symptomatic urinary tract infection in children under 6 years of age. Acta Paediatr , Finnell SM, et al Diagnosis and Management of the Initial UTI in Febrile Infants and Children, 2 to 24 Months. Guideline Pediatrics 128 e , Edlin RS, et al Antibiotic resistance patterns of outpatient pediatric urinary tract infections. J Urol , Strohmeier Y, et al Antibiotics for acute pyelonephritis in children Review. The Cochrane Library Issue 7, Jacobson SH, et al Development of hypertension and uraemia after pyelonephritis in childhood 27 year follow up. BMJ , Cincinnati Children s Hospital Medical Center CCHMC Evidence based care guideline for medical management of first urinary tract infection for children 12 years of age or less. Guideline , Shaikh N, et al Identification of children and adolescents at risk for renal scarring after a first urinary tract infection a meta analysis with individual patient data. JAMA Pediatr , Shaikh N, et al Risk of renal scarring in children with a first urinary tract infection a systematic

5 review. Pediatrics , Mir S, et al Risk factors for renal scarring in children with primary vesicoureteral reflux disease. Saudi J Kidney Dis Transpl , Hiraoka M, et al Early treatment of urinary infection prevents renal damage on cortical scintigraphy. Pediatr Nephrol , Oh MM, et al The impact of therapeutic delay time on acute scintigraphic lesion and ultimate scar formation in children with first febrile UTI. Eur J Pediatr , Ian K, et al Early treatment of acute pyelonephritis in children fails to reduce renal scarring date from the Italian renal infection study trials. Pediatrics , National institute for Health and Clinical Excellence Urinary tract infection in children. CG54. NICE, London, Logvinenko T, et al Predictive value of specific ultrasound findings when used as a screening test for abnormalities on VCUG. J Pediatr Urol e1 7, Bush NC, et al Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI. J Pediatr Urol e1 7, Nelson CP, et al Ultrasound as a screening test for genitourinary anomalies in children with UTI. Pediatrics e , Trisha M, et al Incidence of abnormal imaging and recurrent pyelonephritis after first febrile urinary tract infection in children 2 to 24 months old. J Urol , VUR Craig A, et al Summary of AUA Guideline on Management of Primary Vesicoureteral Reflux in Children. J Urol , Narchi H, et al Renal tract abnormalities missed in a histrical cohort of young children with UTI if the NICE and AAP imaging guidelines were applied. Apr 21. pii S , Ristola MT, et al Consequences of following the new American Academy of Pediatrics guidelines for imaging children with urinary tract infection. Scand J Urol 7 1 5, Ristola MT, et al NICE Guidelines cannot be recommended for imaging studies in children younger than 3 years with urinary tract infection. Eur J Pediatr Surg , RIVUR Trial Investigators, et al Antimicrobial prophylaxis for children with vesicoureteral reflex. N Engl J Med , Roussey Kesler G, et al Antibiotic prophylaxis for the prevention of recurrent urinary tract infection in children with low grade vesicoureteral reflex results from a prospective randomized study. J Urol , Cheng CH, et al Antibiotic resistance patterns of community acquired urinary trect infections in children with vesicoureteral reflux receiving prophylactic antibiotic therapy. Pediatrics , Craig JC, et al Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med , Holmdahla G, et al The Swedish reflux trial in children. Vesicoureteral reflux outcome. J Urol , Joda U, et al Ten year results of randomized treatment of children with severe vesicoureteral reflux. Final report of the International Reflux Study in Children. Pediatr Nephrol , 2006

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