Abstract: Background　Urinary tract infections（UTIs） are common in children，mostly caused by Escherichia coli. Some children with UTIs may have convulsion，which aggravates the condition and prolongs the treatment time. However，there have been no studies comparing inflammatory indicators and pathogenic bacteria between UTIs children with and without convulsion. Objective　To perform a comparative analysis of inflammatory indicators，common pathogenic bacteria and antibiotic resistance between UTIs children with and without convulsion，providing evidence for clinical treatment. Methods　We enrolled 181 children with UTIs from Wuxi Children's Hospital during 2010 to 2019，including 81 with convulsion（convulsive group），and 100 without （non-convulsive group） . Data about sex，age，results of routine blood test （WBC，CRP，PCT），urine culture test and sensitivity test of two groups were collected. Results　Convulsive group had higher average PCT level （P<0.05）. Forty species of pathogenic bacteria（49.4%） were isolated from the samples of convulsive cases，47.5% of which（19/40） were gram-negative bacteria，and 52.5%（21/40） were gram-positive bacteria. Twenty-seven species of pathogenic bacteria（27.0%） were isolated from the samples of non-convulsive cases，85.2% of which（23/27） were gram-negative bacteria，and 14.8%（4/27） were gram-positive bacteria. No fungus was isolated from samples of both groups. Escherichia coli was the most common bacterium infected in both groups. The difference in the prevalence of infected Escherichia coli and non-Escherichia coli between the two groups was statistically significant （P < 0.05）. Escherichia coli had a high resistance rate to ampicillin（93.3%），cefazolin（86.7%） and ceftriaxone（73.3%），and a low resistance rate to imipenem（0），cefotetan（0），ertapenem（0）. Enterococcus faecium had a high resistance rate above 80.0% to ampicillin（92.3%），clindamycin（100.0%），erythromycin（84.6%），and penicillin G（92.3%），and a low resistance rate to vancomycin（0），linezolid（0） and nitrofurantoin（23.1%）. Conclusion　For children with UTIs，attentions should be given to the detection of PCT and timely assessment of infection level，to guide clinical treatment of controlling infection，and reducing the risk of convulsion promptly. For those also with convulsion，clinical focus should be given to midstream urine culture and sensitivity test，and appropriate selection of effective antibiotics to control the disease progression in time.

Key words: Urinary tract infections, Child, Convulsions, Pathogenic bacteria, Drug sensitive test, Inflammation

摘要： 背景　儿童泌尿道感染是常见的感染性疾病，多由大肠埃希菌感染所致，部分泌尿道感染患儿在疾病发展过程中会出现惊厥发作，从而加重病情、延长治疗时间。然而截至目前，关于儿童泌尿道感染发生惊厥的炎性指标情况、泌尿道感染合并惊厥患儿的病原菌与非惊厥者有无区别尚无报道。目的　分析泌尿道感染患儿合并惊厥的炎性指标、常见病原菌及药物耐药性，为临床治疗提供参考。方法　选取2010—2019年无锡市儿童医院收治的81例泌尿道感染合并惊厥患儿（惊厥组），同时选取100例泌尿道感染不伴惊厥患儿（非惊厥组）。收集研究对象的性别、年龄、实验室检查结果〔C反应蛋白（CRP）水平、白细胞计数（WBC）、降钙素原（PCT）〕、尿培养+药敏试验结果。结果　惊厥组PCT水平高于非惊厥组（P<0.05）。惊厥组尿培养出病原菌40株（49.4%），其中革兰阴性菌19株（47.5%），革兰阳性菌21株（52.5%），真菌0株。非惊厥组尿培养出病原菌27株（27.0%），其中革兰阴性菌23株（85.2%），革兰阳性菌4株（14.8%），真菌0株。两组间均以大肠埃希菌最多见。两组间病原菌（大肠埃希菌、非大肠埃希菌）比较，差异有统计学意义（P<0.05）。大肠埃希菌对氨苄西林、头孢唑林、头孢曲松耐药率均较高（93.3%、86.7%、73.3%），对亚胺培南、头孢替坦、厄他培南耐药率均较低（0、0、0）。屎肠球菌对氨苄西林、克林霉素、红霉素、青霉素G 耐药率均在80.0%以上（92.3%、100.0%、84.6%、92.3%），对万古霉素、利奈唑胺及呋喃妥因耐药率低（0、0、23.1%）。结论　泌尿系感染患儿，临床上要重视炎性指标（PCT）的检测，及时有效地评估感染程度，指导临床治疗、尽快控制感染，减少惊厥发作。同时应特别重视泌尿道感染合并惊厥患儿的中段尿培养检查，注意病原菌耐药性，尽早合理选择有效抗菌药物，及时控制病情进展。

关键词: 泌尿道感染, 儿童, 惊厥, 病原菌, 药敏试验, 炎症