Báo cáo nghiên cứu khoa học: Tỷ lệ mắc và vi khuẩn gây bệnh nhiễm trùng đường tiết niệu ở trẻ em từ 2 tháng đến 6 tuổi trong một số lĩnh vực của Hải Phòng, Việt Nam trong năm 2008

Tuyển tập các nghiên cứu khoa học của trường đại học Huế đề tài: Tỷ lệ mắc và vi khuẩn gây bệnh nhiễm trùng đường tiết niệu ở trẻ em từ 2 tháng đến 6 tuổi trong một số lĩnh vực của Hải Phòng, Việt Nam trong năm 2008...
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Báo cáo nghiên cứu khoa học: "Tỷ lệ mắc và vi khuẩn gây bệnh nhiễm trùng đường tiết niệu ở trẻ em từ 2 tháng đến 6 tuổi trong một số lĩnh vực của Hải Phòng, Việt Nam trong năm 2008"JOURNAL OF SCIENCE, Hue University, N0 61, 2010 THE INCIDENCE AND CAUSATIVE BACTERIA OF URINARY TRACT INFECTION IN CHILDREN FROM 2 MONTHS TO 6 YEARS OLD IN SOME AREAS OF HAI PHONG, VIETNAM IN 2008 Nguyen Ngoc Sang, Dang Van Chuc Hai Phong Medical University SUMMARY This study was done to assess the incidence of urinary tract infection (UTI) inchildren from 2 months to 6 years old in some areas of Haiphong Vietnam, and bacterialcauses and their antibiotic sensitivity on antibiogram from July to October 2007.Method: This was a cross-sectional study including the screening of clean voidingmidstream samples in the morning for UTI. UTI was defined as the combination of bothleucocyturia (≥ 30/mm3 urine) and bacteriuria (≥ 105/ml urine). Results andConclusions: The common incidence rate was 2.8%, UTI affected more girls than boys(3.3% vs. 2.2%). Causal bacteria was mainly negative gram and E. coli ranks first thenProteus and Klebsiella. In addition, we found other bacteria such as Enterobacter andCitrobacter. The bacteria was resistant to oral antibiotics but still sensitive to the thirdgeneration of cephalosporines, amikacines and quinolone group. Keyword: Urinary Tract Infection in children.1. Introduction Urinary Tract Infection (UTI) is a disease commonly found in children.According to the WHO 3-8% of young girls and 1-3.0% of young boys have contractedUTIs by the age of seven. UTIs may cause kidney scars (15.1%), which results in dangerous complicationsas the child grows older. These include anemia, hypertension (7-17%), prenatalconvulsion, puerperal eclampsia in girls as they grow up, kidney failure and final stagekidney diseases. UTI causes considerable damage to the economy: The US governmenthas to spend US$ 1.6 billion per year on UTI. UTI bacteria have grown resistant toantibiotics at a high level. We posed the questions: What is the rate of UTI researched inhospitals and in the community?, is UTI bacteria the same as the UTI bacteria inhospital and what is their sensitivity to antibiotics? In order to answer these questions,we conducted this study with an aim to identify the UTI incidence among children agedbetween two months and six years of age in a number of areas in Haiphong, Vietnam 385and identify the causal bacteria and their sensitivity to antibiotics on an antibiogram.2. Methods 2.1. Subject and research period - All children between two months and six years of age in a number of areas inHaiphong Vietnam. - Research period: July 2007 through October 2007. - UTI diagnosis criteria: urinary leukocyte ≥ 30/mm3 and urinary bacteria ≥105/ml of urine. 2.2. Methods - Research area: 3 selected districts, including Kien An (urban), Kien Thuy(coastal) and Thuy Nguyen (rural). 9 selected wards/ communes include Nam Son,Trang Minh and Van Dau (Kien An), Dai Ha, Tan Trao and Ngu Doan (Kien Thuy),Phuc Le, Lap Le and Pha Le (Thuy Nguyen). - Research design: Cross-sectional study. - Sample size: calculated with the following formula: p 1  p  n  Z 12  /2 d2 n: Sample size researched Z21-α/2 = 1.96 (reliability: 95%) p = 0.04 ( UTI rate in children in a ward of Hong Bang district, Haiphong,according to a study conducted by Nguyen Ngoc Sang et al 2005) d: desired accuracy = (p*)  = 0.2 Applying the formula, we calculated that the number of children to beresearched is around 4610. - Sampling: Sampling was done with the multi-stage method. In stage 1 districtswere deliberately selected. In stage 2 communes/ wards were randomly selected and instage 3 households were randomly selected. - Data collection: Urine screening includes 3 steps: Step 1. Urinary leukocyte screening. A US made 10-parameter urine analyzing machine - Model TC 101-TECO wasused to screen urinary leukocytes. If there are ≥ 30 leukocytes per mm3 then the urine 386sample of this child was transferred in order to cultivate and divide bacteria. Midstreamurine was collected in the morning. The genital area was washed clean with soapy waterthe night before and before the urine is obtained. Step 2. Cultivating urine to identify urinary leukocytes: In accordance with theprocess of the World Health Organization to detect and determine the ...