vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v11i5.432vsp-431Research ArticleНЕПРЕРЫВНОЕ ПРОФЕССИОНАЛЬНОЕ ОБРАЗОВАНИЕPROFESSIONAL DEVELOPMENTИНФЕКЦИИ МОЧЕВЫХ ПУТЕЙ У ДЕТЕЙ: ЭТИОПАТОГЕНЕЗ, КЛИНИЧЕСКАЯ КАРТИНА, ДИАГНОСТИКА, СОВРЕМЕННЫЕ ПОДХОДЫ К ТЕРАПИИURINARY TRACT INFECTIONS IN CHILDREN: ETIOLOGY AND PATHOGENESIS, CLINICAL MANIFESTATION, DIAGNOSTICS, MODERN APPROACHES TO THERAPYЕсаянА. М.EsayanA. M.essaian.ashot@gmail.comНимгироваА. Н.NimgirovaA. N.essaian.ashot@gmail.comСанкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияI.P. Pavlov St. Petersburg State Medical UniversityRussian Federation201219092012115Вопросы современной педиатрии7985Copyright © Есаян А.М., Нимгирова А.Н., 20122012Есаян А.М., Нимгирова А.Н.Esayan A.M., Nimgirova A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/431

Работа посвящена наиболее распространенной патологии инфекционной природы у детей — инфекции мочевых путей. Анализируются вопросы этиологии, патогенеза, классификации, клинико-диагностических подходов, описаны современные методы лечения.

The article covers the problem of urinary tract infections, which are the most common infectious diseases in children. The authors analyze etiology, pathogenesis, classification and clinical and diagnostic approaches to such patients. The modern methods of treatment are described in the article.t.

 

детиинфекции мочевых путейдиагностикаантибактериальная терапияchildrenurinary tract infectionsdiagnosticsantibacterial treatmentReferencesBeetz R. May we go on with antibacterial prophylaxis for urinary tract infections? Pediatric Nephrology. 2006; 21 (1): 5–13.Beetz R. May we go on with antibacterial prophylaxis for urinary tract infections? Pediatric Nephrology. 2006; 21 (1): 5–13.Vachvanichsanong P. Urinary tract infection: one lingering effect of childhood kidney diseases — review of the literature. J. Nephrology. 2007; 20 (1): 21–28.Vachvanichsanong P. Urinary tract infection: one lingering effect of childhood kidney diseases — review of the literature. J. Nephrology. 2007; 20 (1): 21–28.Quigley R. Diagnosis of urinary tract infections in children. Curr. Opin. Ped. 2009; 21 (2): 194–198.Quigley R. Diagnosis of urinary tract infections in children. Curr. Opin. Ped. 2009; 21 (2): 194–198.Yang S., Chiang I., Lin C. D. et al. Advances in non-surgical treatments for UTIs in children. World J. Urol. 2012; 30 (1): 69–75.Yang S., Chiang I., Lin C. D. et al. Advances in non-surgical treatments for UTIs in children. World J. Urol. 2012; 30 (1): 69–75.Bhat R. G., Katy T. A., Place F. C. Pediatric urinary tract infections. Emerg. Med. Clin. North Am. 2011; 29 (3): 637–653.Bhat R. G., Katy T. A., Place F. C. Pediatric urinary tract infections. Emerg. Med. Clin. North Am. 2011; 29 (3): 637–653.L'opez Sastre J. B., Aparicio A. R., Coto Cotallo G. D. et al. Urinary tract infection in the newborn: clinical and radio imaging studies. Pediatric Nephrology. 2007; 22 (10): 1735–1741.L'opez Sastre J. B., Aparicio A. R., Coto Cotallo G. D. et al. Urinary tract infection in the newborn: clinical and radio imaging studies. Pediatric Nephrology. 2007; 22 (10): 1735–1741.Bauer R., Kogan B. A. New developments in the diagnosis and management of pediatric UTIs. Urol. Clin. North Am. 2008; 35 (1): 47–58.Bauer R., Kogan B. A. New developments in the diagnosis and management of pediatric UTIs. Urol. Clin. North Am. 2008; 35 (1): 47–58.Clark C. J., Kennedy W. A., Shortliffe L. D. Urinary tract infection in children: when to worry. Urol. Clin. North Am. 2010; 37 (2): 229–241.Clark C. J., Kennedy W. A., Shortliffe L. D. Urinary tract infection in children: when to worry. Urol. Clin. North Am. 2010; 37 (2): 229–241.Williams G. J., Lee A., Craig J. C. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database of Systematic Revi. 2001; 4: ID CD001534.Williams G. J., Lee A., Craig J. C. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database of Systematic Revi. 2001; 4: ID CD001534.Conway P. H., Cnaan A., Zaoutis T. et al. Recurrent urinary tract infections in children: risk factors and association with prophylactic antimicrobials. J. Am. Med. Ass. 2007; 298 (2): 179–186.Conway P. H., Cnaan A., Zaoutis T. et al. Recurrent urinary tract infections in children: risk factors and association with prophylactic antimicrobials. J. Am. Med. Ass. 2007; 298 (2): 179–186.Shaikh N., Morone N. E., Bost J. E. et al. Prevalence of urinary tract infection in childhood: a metaanalysis. Pediatr. Infect. Dis. J. 2008; 27 (4): 302–308.Shaikh N., Morone N. E., Bost J. E. et al. Prevalence of urinary tract infection in childhood: a metaanalysis. Pediatr. Infect. Dis. J. 2008; 27 (4): 302–308.Linshaw M. Asymptomatic bacteriuria and vesicoureteral reflux in children. Kidney Int. 1996; 50 (1): 312–329.Linshaw M. Asymptomatic bacteriuria and vesicoureteral reflux in children. Kidney Int. 1996; 50 (1): 312–329.Hoberman A., Wald E. R., Hickey R. W. et al. Oral versus initial intravenous therapy for urinary tract infections in young febrile children. Pediatrics. 1999; 104 (1): 79–86.Hoberman A., Wald E. R., Hickey R. W. et al. Oral versus initial intravenous therapy for urinary tract infections in young febrile children. Pediatrics. 1999; 104 (1): 79–86.Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am. J. Med. 2002; 113 (1): 14.Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Am. J. Med. 2002; 113 (1): 14.Sobel J. D., Vazquez J. A. Fungal infections of the urinary tract. World J. Urol. 1999; 17 (6): 410–414. 16. Малаховский Е. Ю., Савинич Е. В., Макарец Б. Г. и др. О некоторых подходах к диагностике и терапии инфекции мочевыводящих путей у детей. Педиатрия. 1998; 3: 100–104.Sobel J. D., Vazquez J. A. Fungal infections of the urinary tract. World J. Urol. 1999; 17 (6): 410–414. 16. Малаховский Е. Ю., Савинич Е. В., Макарец Б. Г. и др. О некоторых подходах к диагностике и терапии инфекции мочевыводящих путей у детей. Педиатрия. 1998; 3: 100–104.Bensman A. Should children with asymptomatic bacteriuria (ABU) undergo imaging studies of the urinary tract. Pediatr. Nephrol. 2002; 17 (1): 76–77.Bensman A. Should children with asymptomatic bacteriuria (ABU) undergo imaging studies of the urinary tract. Pediatr. Nephrol. 2002; 17 (1): 76–77.Liao J. C. Churchill B. M. Pediatric urine testing. Pediatr. Clin. North. Am. 2001; 48 (6): 1425–1440.Liao J. C. Churchill B. M. Pediatric urine testing. Pediatr. Clin. North. Am. 2001; 48 (6): 1425–1440.Вербицкий В. И., Чугунова О. Л., Яковлева С. В. и др. Особенности течения, клиники, диагностики и лечения некоторых заболеваний органов мочевой системы у детей раннего возраста. Педиатрия. 2002; 2: 4–9.Вербицкий В. И., Чугунова О. Л., Яковлева С. В. и др. Особенности течения, клиники, диагностики и лечения некоторых заболеваний органов мочевой системы у детей раннего возраста. Педиатрия. 2002; 2: 4–9.Ottolini M. C., Shaer C. M., Rushton H. G. et al. Relationship of asymptomatic bacteriuria and renal scarring in children with neuropathic bladders who are practicing clean intermittent catheterization. J. Pediatr. 1995; 127 (3): 368–372.Ottolini M. C., Shaer C. M., Rushton H. G. et al. Relationship of asymptomatic bacteriuria and renal scarring in children with neuropathic bladders who are practicing clean intermittent catheterization. J. Pediatr. 1995; 127 (3): 368–372.Zelikovic I., Adelman R. D., Nancarrow P. A. Urinary tract infections in children. An update. West J. Med. 1992; 157: 554–561.Zelikovic I., Adelman R. D., Nancarrow P. A. Urinary tract infections in children. An update. West J. Med. 1992; 157: 554–561.Лопаткин И. А., Пугачев А. Г. Детская урология: Рук-во. М.: Медицина. 1986. 494 с.Лопаткин И. А., Пугачев А. Г. Детская урология: Рук-во. М.: Медицина. 1986. 494 с.Панченко Е. Л. Некоторые аспекты инфекции мочевыводящих путей у детей. Педиатрия. 1998; 3: 106–108.Панченко Е. Л. Некоторые аспекты инфекции мочевыводящих путей у детей. Педиатрия. 1998; 3: 106–108.Jantunen M. E., Siitonen A., Ala-Houhala M. et al. Predictive factors associated with significant urinary tract abnormalities in infants with pyelonephritis. Pediatr. Infect. Dis. J. 2001: 20 (6): 597–601.Jantunen M. E., Siitonen A., Ala-Houhala M. et al. Predictive factors associated with significant urinary tract abnormalities in infants with pyelonephritis. Pediatr. Infect. Dis. J. 2001: 20 (6): 597–601.Stapleton F. B. Imaging studies for childhood urinary infections. N. Engl. J. Med. 2003; 348 (3): 251–252.Stapleton F. B. Imaging studies for childhood urinary infections. N. Engl. J. Med. 2003; 348 (3): 251–252.Yoshida J., Tsuchiya M., Tatsuma N. et al. Mass screening for early detection of congenital kidney and urinary tract abnormalities in infancy. Pediatr. Int. 2003; 45 (1): 142–149.Yoshida J., Tsuchiya M., Tatsuma N. et al. Mass screening for early detection of congenital kidney and urinary tract abnormalities in infancy. Pediatr. Int. 2003; 45 (1): 142–149.Garcia F. J., Nager A. L. Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics. 2002; 109 (5): 846–851.Garcia F. J., Nager A. L. Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics. 2002; 109 (5): 846–851.Shaw K. N., Gorelick M., McGowan K. L. et al. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatrics. 1998; 102 (2): 16–21.Shaw K. N., Gorelick M., McGowan K. L. et al. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatrics. 1998; 102 (2): 16–21.Crain E. F., Gershel J. C. Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatrics. 1990; 86 (3): 363–367.Crain E. F., Gershel J. C. Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatrics. 1990; 86 (3): 363–367.Levine D. A., Platt S. L., Dayan P. S. et al. Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections. Pediatrics. 2004; 113 (6): 1728–1734.Levine D. A., Platt S. L., Dayan P. S. et al. Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections. Pediatrics. 2004; 113 (6): 1728–1734.Smyslowska A., Kozlowski J., Zielinska E. et al. Urinary tract infections in children under three years of age. Pol. Mercuriusz Lek. 2003; 82 (4): 319–321.Smyslowska A., Kozlowski J., Zielinska E. et al. Urinary tract infections in children under three years of age. Pol. Mercuriusz Lek. 2003; 82 (4): 319–321.Прокопенко Ю. Д. Диагностика первичного гнойного пиелонефрита у детей. Дет. хирургия. 2004; 3: 19–22.Прокопенко Ю. Д. Диагностика первичного гнойного пиелонефрита у детей. Дет. хирургия. 2004; 3: 19–22.Юшко Е. И., Скобеюс И. А., Апцешко А. Д. и др. Факторы, влияющие на выбор лечения первичного обструктивного мегауретера (ПОМУ) у новорожденных и детей грудного возраста. Мат-лы Пленума правл. Рос. об-ва урологов. Тюмень. 2005. С. 202–203.Юшко Е. И., Скобеюс И. А., Апцешко А. Д. и др. Факторы, влияющие на выбор лечения первичного обструктивного мегауретера (ПОМУ) у новорожденных и детей грудного возраста. Мат-лы Пленума правл. Рос. об-ва урологов. Тюмень. 2005. С. 202–203.Cochat P., Marquet L. Infections urinaires de l'enfant. Leucocyturie. Rev. Prat. 2003; 53 (5): 571–575.Cochat P., Marquet L. Infections urinaires de l'enfant. Leucocyturie. Rev. Prat. 2003; 53 (5): 571–575.National Institute for Health and Clinical Excellence, Urinary Tract Infection in Children: Diagnosis, Treatment and Long-Term Management. National Institute of Health and Clinical Excellence. London, UK. 2007.National Institute for Health and Clinical Excellence, Urinary Tract Infection in Children: Diagnosis, Treatment and Long-Term Management. National Institute of Health and Clinical Excellence. London, UK. 2007.Pryles C. V. The diagnosis of urinary tract infection. Pediatrics. 1960; 26: 441–451.Pryles C. V. The diagnosis of urinary tract infection. Pediatrics. 1960; 26: 441–451.Zorc J. J., Kiddoo D. A., Shaw K. N. Diagnosis and management of pediatric urinary tract infections. Clin. Microbiol. Rev. 2005; 18 (2): 417–422.Zorc J. J., Kiddoo D. A., Shaw K. N. Diagnosis and management of pediatric urinary tract infections. Clin. Microbiol. Rev. 2005; 18 (2): 417–422.Prajapati B. S., Prajapati R. B., Patel P. S. Advances in management of urinary tract infections. Ind. J. Pediatr. 2008; 75 (8): 809–814.Prajapati B. S., Prajapati R. B., Patel P. S. Advances in management of urinary tract infections. Ind. J. Pediatr. 2008; 75 (8): 809–814.Newman T. B., Bernzweig J. A., Takayama J. I. et al. Urine testing and urinary tract infections in febrile infants seen in office settings: the pediatric research in office settings «febrile infant study». Arch. Pediatr. Adolesc. Med. 2002; 156 (1): 44–54.Newman T. B., Bernzweig J. A., Takayama J. I. et al. Urine testing and urinary tract infections in febrile infants seen in office settings: the pediatric research in office settings «febrile infant study». Arch. Pediatr. Adolesc. Med. 2002; 156 (1): 44–54.UTI Clinical practice guidelines for the diagnosis and management of initial UTI in febrile infants and children 2–24 months of age. Pediatrics. 2011; 128: 595.UTI Clinical practice guidelines for the diagnosis and management of initial UTI in febrile infants and children 2–24 months of age. Pediatrics. 2011; 128: 595.NGC Guidelines: urinary tract infection in children: diagnosis, treatment and long-term management. 2007.NGC Guidelines: urinary tract infection in children: diagnosis, treatment and long-term management. 2007.Keren R., Chan E. A meta-analysis of randomized, controlled trials comparing short- and long-course antibiotic therapy for urinary tract infections in children. Pediatrics. 2002; 109 (5): 70.Keren R., Chan E. A meta-analysis of randomized, controlled trials comparing short- and long-course antibiotic therapy for urinary tract infections in children. Pediatrics. 2002; 109 (5): 70.Kumazawa J., Yagisawa M. The history of antibiotics: The Japanese story. J. Infect. Chemother. 2002; 8: 125–133.Kumazawa J., Yagisawa M. The history of antibiotics: The Japanese story. J. Infect. Chemother. 2002; 8: 125–133.Braga P. C., Piatti G. Kinetics of filamentation of Escherichia coli induced by different sub-MICs of ceftibuten at different times. Chemotherapy. 1993; 39: 272–277.Braga P. C., Piatti G. Kinetics of filamentation of Escherichia coli induced by different sub-MICs of ceftibuten at different times. Chemotherapy. 1993; 39: 272–277.Jones R. N., Barry A. L. Antimicrobial activity, spectrum and recommendations for disk diffusion susceptibility testing of cefti buten (7432-S; SGH 39720), a new orally administered cephalosporin. Antimicrob. Agents Chemother. 1988; 32: 1576–1582.Jones R. N., Barry A. L. Antimicrobial activity, spectrum and recommendations for disk diffusion susceptibility testing of cefti buten (7432-S; SGH 39720), a new orally administered cephalosporin. Antimicrob. Agents Chemother. 1988; 32: 1576–1582.Craig W. A., Andes D. Pharmacokinetics and pharmacodynamics of antibiotics in otitis media. Pediatr. Infect. Dis. J. 1996; 15: 255–229.Craig W. A., Andes D. Pharmacokinetics and pharmacodynamics of antibiotics in otitis media. Pediatr. Infect. Dis. J. 1996; 15: 255–229.Reidenberg B. E. Worldwide safety experience with ceftibuten pediatric suspension. Pediatr. Infect. Dis. J. 1995; 14 (7): 130–133.Reidenberg B. E. Worldwide safety experience with ceftibuten pediatric suspension. Pediatr. Infect. Dis. J. 1995; 14 (7): 130–133.Marild S., Jodal U., Sandberg T. Ceftibuten versus trimethoprimsulfamethoxazole for oral treatment of febrile urinary tract infection in children. Pediatr. Nephrol. 2009; 24 (3): 521–526.Marild S., Jodal U., Sandberg T. Ceftibuten versus trimethoprimsulfamethoxazole for oral treatment of febrile urinary tract infection in children. Pediatr. Nephrol. 2009; 24 (3): 521–526.Maioli E., Marchese A., Roveta S. et al. In vitro activity of ceftibuten at sub-inhibitory concentrations in comparison with other antibiotics against respiratory and urinary tract pathogens. J. Chemother. 2007; 19 (2): 152–160.Maioli E., Marchese A., Roveta S. et al. In vitro activity of ceftibuten at sub-inhibitory concentrations in comparison with other antibiotics against respiratory and urinary tract pathogens. J. Chemother. 2007; 19 (2): 152–160.Wiseman L. R., Balfour J. A. Ceftibuten. A review of its antibacterial activity, pharmacokinetic properties and clinical efficacy. Drugs. 1994; 47: 784–808.Wiseman L. R., Balfour J. A. Ceftibuten. A review of its antibacterial activity, pharmacokinetic properties and clinical efficacy. Drugs. 1994; 47: 784–808.

The authors declare that there are no conflicts of interest present.