Abstract：
To investigate the risk factors for recurrent urinary tract infection (UTI) in children with a neurogenic bladder (NB) managed by clean intermittent catheterization.
Over a 5-year period, we retrospectively assessed the risk factors for recurrent UTIs in children (age 9-151 months) who had clean intermittent catheterization. All patients were followed up for more than 12 months and had at least two clinic visits during the study period. Demographic, clinical, and urodynamic parameters were assessed. All data were compared between the recurrent UTI (>1.0 UTI/study-year) and episodic UTI (≤1.0 UTI/study-year) groups.
Of 327 patients, 79 (24.2%) had recurrent UTIs and 248 (75.8%) had episodic UTIs. Univariate and multivariate analyses showed that older age, lumbar level lesions, long duration of NB, presence of vesicoureteral reflux, increased bladder wall thickness, and low bladder compliance were the significant factors for recurrent UTIs. Bladder trabeculation was associated with recurrent UTIs on univariate analysis, but not on multivariate analysis. During the follow-up period, chronic renal insufficiency was diagnosed in 31 (39.2%) and 29 patients (11.7%) in the recurrent and episodic UTI groups (P <.05), respectively.
These results suggest that older age, high level of spinal cord lesions, long duration of NB, vesicoureteral reflux, increased bladder wall thickness, and low bladder compliance may be directly associated with recurrent UTIs in children with NB. Children with NB might have higher susceptibility to chronic renal insufficiency after recurrent UTIs.
Over a 5-year period, we retrospectively assessed the risk factors for recurrent UTIs in children (age 9-151 months) who had clean intermittent catheterization. All patients were followed up for more than 12 months and had at least two clinic visits during the study period. Demographic, clinical, and urodynamic parameters were assessed. All data were compared between the recurrent UTI (>1.0 UTI/study-year) and episodic UTI (≤1.0 UTI/study-year) groups.
Of 327 patients, 79 (24.2%) had recurrent UTIs and 248 (75.8%) had episodic UTIs. Univariate and multivariate analyses showed that older age, lumbar level lesions, long duration of NB, presence of vesicoureteral reflux, increased bladder wall thickness, and low bladder compliance were the significant factors for recurrent UTIs. Bladder trabeculation was associated with recurrent UTIs on univariate analysis, but not on multivariate analysis. During the follow-up period, chronic renal insufficiency was diagnosed in 31 (39.2%) and 29 patients (11.7%) in the recurrent and episodic UTI groups (P <.05), respectively.
These results suggest that older age, high level of spinal cord lesions, long duration of NB, vesicoureteral reflux, increased bladder wall thickness, and low bladder compliance may be directly associated with recurrent UTIs in children with NB. Children with NB might have higher susceptibility to chronic renal insufficiency after recurrent UTIs.
摘要：
探讨清洁间歇导尿治疗神经源性膀胱(NB)患儿复发性尿路感染(UTI)的危险因素。
在5年的时间里,我们回顾性评估了接受清洁间歇性导尿的儿童(9~151个月)复发性UTI的危险因素.所有患者均接受了超过12个月的随访，并且在研究期间至少进行了两次临床就诊。人口统计,临床,和尿动力学参数进行了评估。比较复发性UTI（>1.0UTI/研究年）和发作性UTI（≤1.0UTI/研究年）组之间的所有数据。
327名患者中,79例(24.2%)患有复发性尿路感染，248例(75.8%)患有偶发性尿路感染。单变量和多变量分析表明，年龄较大，腰椎病变,NB持续时间长，膀胱输尿管反流的存在，膀胱壁厚度增加，低膀胱顺应性是复发性UTI的重要因素。单因素分析显示膀胱小梁形成与复发性尿路感染相关,但不是多变量分析。在后续期间,在复发和发作性UTI组中，31例（39.2%）和29例（11.7%）被诊断为慢性肾功能不全（P<0.05），分别。
这些结果表明，年龄较大，高水平的脊髓病变，NB持续时间长，膀胱输尿管反流,膀胱壁厚度增加，低膀胱顺应性可能与NB患儿的复发性UTI直接相关。患有NB的儿童在复发性UTI后可能对慢性肾功能不全有更高的易感性。
在5年的时间里,我们回顾性评估了接受清洁间歇性导尿的儿童(9~151个月)复发性UTI的危险因素.所有患者均接受了超过12个月的随访，并且在研究期间至少进行了两次临床就诊。人口统计,临床,和尿动力学参数进行了评估。比较复发性UTI（>1.0UTI/研究年）和发作性UTI（≤1.0UTI/研究年）组之间的所有数据。
327名患者中,79例(24.2%)患有复发性尿路感染，248例(75.8%)患有偶发性尿路感染。单变量和多变量分析表明，年龄较大，腰椎病变,NB持续时间长，膀胱输尿管反流的存在，膀胱壁厚度增加，低膀胱顺应性是复发性UTI的重要因素。单因素分析显示膀胱小梁形成与复发性尿路感染相关,但不是多变量分析。在后续期间,在复发和发作性UTI组中，31例（39.2%）和29例（11.7%）被诊断为慢性肾功能不全（P<0.05），分别。
这些结果表明，年龄较大，高水平的脊髓病变，NB持续时间长，膀胱输尿管反流,膀胱壁厚度增加，低膀胱顺应性可能与NB患儿的复发性UTI直接相关。患有NB的儿童在复发性UTI后可能对慢性肾功能不全有更高的易感性。
