Title: Pediatric UTI (Age 2 - 24 Months)
题目：小儿泌尿系感染（年龄 2－24个月）
Author 作者: Lauren Rice
 
--The diagnosis and treatment of pediatric urinary tract infections (UTIs) can be broken down into different age groups. The AAP has recently updated its recommendations for children age 2 - 24 months.
儿童泌尿系感染的诊断和治疗分成不同的年龄组。美国儿科学会最近更新了对2－24个月儿童的建议。
--In ill-appearing febrile infants age 2 – 24 months, who require early initiation of antibiotics, clinicians should obtain urinalysis and urine culture by catheterization or suprapubic aspiration prior to administration of the first dose of antibiotics.
对看起来较重并发热需要尽快给抗菌素的2－24个月的儿童，医生要在给第一个剂量抗菌素前通过插尿管或耻骨上穿刺做尿常规和培养。
--Key components of diagnosing a UTI include: urinalysis with the presence of pyuria (>10 WBCs per µL) and bacteriuria. The ultimate diagnosis relies on identification of >50,000 CFUs per mL of a single urinary pathogen in culture.
诊断UTI的关键是：尿常规里有脓尿（超过10个WBC）和菌尿。最终的诊断要依赖于培养中有超过50，000CFU／ml的单一尿致病菌。
--Treatment of most UTIs in well appearing infants 2-24 months can be done with oral antibiotics for a course of 7-14 days. Common antibiotics used include: amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, or cephalosporins (cefpodoxime, cefixime) based on local patterns of susceptibility.
对看起来病情不重的2－24个月的儿童可用7－14天的口服抗菌素，常用的抗菌素包括：奥格门汀，甲氧苄氨嘧啶 - 磺胺甲基异恶唑，或头孢菌素（头孢泊肟，头孢克肟），要根据当地的抗菌谱选择。
--Febrile infants should undergo renal and bladder ultrasound (RBUS) to evaluate the renal parenchyma and identify complications of UTI in children who are not responding to treatment within 48 hours.
发烧的小孩要做肾和膀胱超声（RBUS），以检查肾实质和发现48小时内对治疗无反应的病人的合并症。
--Voiding cystourethrography (VCUG) to diagnose vesicoureteral reflux (VUR) as a cause of UTI should be only obtained in children with abnormal RBUS or with recurrent febrile UTIs.
用来诊断膀胱输尿管返流（VUR）作为尿路感染原因的排尿膀胱尿道摄影（VCUG），仅仅用于有异常RBUS或复发性发热性UTI的儿童。

References 参考文献：
Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months. Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management. Pediatrics 2011; 595 – 610.