Prevalence of urinary tract infection in febrile young children in the emergency department
Prevalence of urinary tract infection in febrile young children in the emergency department
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DOI：
10.1542/peds.102.2.e16
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发表时间：
1998-08-01
期刊：
影响因子：
8
通讯作者：
Schwartz, JS
中科院分区：
文献类型：
--
作者：
Shaw, KN;Gorelick, M;Schwartz, JS
Objective.通过人口统计学和临床参数确定急诊科（艾德）发热婴儿和年轻女孩的尿路感染（UTI）患病率。对所有12个月以下婴儿和2岁以下女孩中的2411名（83%）进行横断面患病率调查，这些婴儿和女孩因发热（大于或等于38.5 ℃）到艾德就诊，没有明确的发热源，也没有使用抗生素或免疫抑制剂。中耳炎、胃肠炎和上呼吸道感染被认为是潜在的但不确定的发热源。UTI的总体患病率（泌尿道病原体生长大于或等于10（4）CFU/mL）为3.3%（95%置信区间[CI]：2.6，4.0）。白人患病率较高（10.7%; 95% CI：7.1，14.3），女孩（4.3%; 95% CI：3.3，5.3），未行包皮环切术的男孩（8.0%; 95%CI：1.9，14.1），以及没有其他潜在发热源的患者（5.9%; 95% CI：3.8，8.0），有UTI病史（9.3%; 95% CI：3.0，20.3）、尿臭或血尿（8.6%; 95% CI：2.8，19.0），表现为“患病”（5.7%; 95% CI：4.0，7.4），检查时有腹部或耻骨上压痛（13.2%; 95% CI：3.7，30.7），或发热≥ 39 ℃（3.9%; 95% CI：3.0，4.8）。白色女孩的UTI患病率为16.1%（95%CI：10.6，21.6）。UTI在幼儿中普遍存在，特别是白色女孩，没有明确的发热源。UTI的特殊临床体征和症状并不常见，并且存在另一种潜在的发热源，如上呼吸道感染或中耳炎，排除UTI并不可靠。
Objective. Establish prevalence rates of urinary tract infection (UTI) in febrile infants and young girls in an emergency department (ED) by demographics and clinical parameters.Methods. Cross-sectional prevalence survey of 2411 (83%) of all infants younger than 12 months and girls younger than 2 years of age presenting to the ED with a fever (greater than or equal to 38.5 degrees C) who did not have a definite source for their fever and who were not on antibiotics or immunosuppressed. Otitis media, gastroenteritis, and upper respiratory infection were considered potential but not definite sources of fever.Results. Overall prevalence of UTI (growth of greater than or equal to 10(4) CFU/mL of a urinary tract pathogen) was 3.3% (95% confidence interval [CI]: 2.6,4.0). Higher prevalences occurred in whites (10.7%; 95% CI: 7.1,14.3), girls (4.3%; 95% CI: 3.3,5.3), uncircumcised boys (8.0%; 95% CI: 1.9,14.1), and those who did not have another potential source for their fever (5.9%; 95% CI: 3.8,8.0), had a history of UTI (9.3%; 95% CI: 3.0,20.3), malodorous urine or hematuria (8.6%; 95% CI: 2.8,19.0), appeared "ill" (5.7%; 95% CI: 4.0,7.4), had abdominal or suprapubic tenderness on examination (13.2%; 95% CI: 3.7,30.7), or had fever greater than or equal to 39 degrees C (3.9%; 95% CI: 3.0,4.8). White girls had a 16.1% (95% CI: 10.6,21.6) prevalence of UTI.Conclusions. UTI is prevalent in young children, particularly white girls, without a definite source of fever. Specific clinical signs and symptoms of UTI are uncommon, and the presence of another potential source of fever such as upper respiratory infection or otitis media is not reliable in excluding UTI.