Constipation on abdominal radiograph as potential risk factor for recurrent urinary tract infection development.
Constipation on abdominal radiograph as potential risk factor for recurrent urinary tract infection development.
复制标题
腹部X光片上的便秘是复发性尿路感染发展的潜在危险因素。
DOI：
10.1007/s00467-021-04973-5
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Shaikh,Nader
中科院分区：
文献类型：
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作者：
Muniz,Gysella;Kar,Erica;Gumus,Serter;Liu,Hui;Shaikh,Nader
BackgroundTo比较临床病史和测量粪便负荷腹部X线摄影（AR）在预测尿路感染（UTI）复发的children.MethodsWe结合数据从两个多中心纵向研究中，儿童小于6岁的第一个或第二个UTI随访复发的UTI。两名放射科医生审查了两个参与研究中心儿童入组时获得的初始排尿膀胱尿道造影片的侦察腹部X线片，并测量了结肠各部分可见的粪便。我们检查了临床变量（例如，排尿和肠道的历史，使用轻泻药在登记）和粪便负荷的测量预测复发UTIwithin 12个月的enrollment.Results192名儿童被列入。在单变量分析中，年龄、膀胱输尿管反流（VUR）、盲肠直径、直肠直径和AR上的总粪便长度与UTI复发相关。在控制年龄后，基线时有VUR的儿童复发UTI的几率比无VUR的儿童高3.85（95%CI：1.62，9.14）。盲肠直径> 3.10 cm的儿童比盲肠直径较低的儿童复发UTI的可能性高2.57倍（95%CI：1.01，6.55）;盲肠直径升高的儿童首次复发UTI的时间较短（p= 0.0023）。然而，它的准确性是次优作为筛选测试。因此，不支持将其常规用于该适应症。如果因其他适应症而订购的AR上的盲肠直径> 3.10 cm，则可以考虑便秘管理。
BackgroundTo compare clinical history and measurements of fecal load on abdominal radiography (AR) in the prediction of urinary tract infection (UTI) recurrence in children.MethodsWe combined data from two multicenter longitudinal studies in which children less than 6 years of age with a first or second UTI were followed for recurrence of UTI. Two radiologists reviewed the scout abdominal radiographs of initial voiding cystourethrograms obtained at enrollment from children at two participating sites and measured stool visible in various parts of the colon. We examined how well clinical variables (e.g., voiding and bowel history, use of laxatives at enrollment) and measurements of fecal load predicted recurrence of UTI within 12 months of enrollment.ResultsOne hundred and ninety-two children were included. On univariate analyses, age, vesicoureteral reflux (VUR), cecal diameter, rectal diameter, and total stool length on AR were associated with recurrence of UTI. After controlling for age, the odds of recurrent UTI in children with VUR at baseline was 3.85 (95% CI: 1.62, 9.14) higher than in children without VUR. Recurrent UTI was 2.57 (95% CI: 1.01, 6.55) times more likely in children with cecal diameter > 3.10 cm than children with lower cecal diameters; time to first recurrent UTI was shorter in children with elevated cecal diameters (p= 0.0023).ConclusionsCecal diameter on abdominal radiographs predicts UTI recurrence in children with a previous UTI. However, its accuracy is suboptimal to serve as a screening test. Accordingly, its routine use for this indication is not supported. If cecal diameter on an AR ordered for another indication is > 3.10 cm, then management of constipation could be considered.