Risk Factors for the Development of Febrile Recurrences in Children with a History of Urinary Tract Infection.
Risk Factors for the Development of Febrile Recurrences in Children with a History of Urinary Tract Infection.
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DOI：
10.1016/j.jpeds.2021.12.037
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Shaikh N
中科院分区：
文献类型：
--
作者：
Hum S;Liu H;Shaikh N
确定有尿路感染（UTI）病史的儿童中尿路感染（UTI）发热复发的危险因素。我们纳入了500名年龄在2至72个月之间、有UTI病史的儿童，他们在之前进行的两项研究（RIVUR和CUTIE）的背景下前瞻性随访了约2年。我们使用单变量和多变量logistic回归分析确定了未接受抗菌药物预防的儿童中发热复发的重要危险因素。在单变量分析中，非黑人种族、发热指数UTI、肠膀胱功能障碍、IV级膀胱输尿管反流、基线时肾瘢痕形成和肾膀胱超声异常与发热复发相关。在多变量分析中，下列变量独立增加了发热复发的几率（比值比; 95%置信区间）：非黑人（7.1; 1.5-127.9），肠-膀胱功能障碍（2.6; 1.1-5.3），发热指数UTI（2.5; 1.1-6.9），肾脏-膀胱超声检查异常（2.6; 1.2-5.6）、IV级膀胱输尿管反流（3.9; 1.4-10.5）和基线肾瘢痕形成（4.7; 1.2-19.1）。非黑人和IV级膀胱输尿管反流增加UTI发热复发的几率。虽然我们的研究结果应该刺激其他研究进一步探讨种族和UTI之间的关系，鉴于种族和UTI复发之间的联系尚不清楚，种族不应该被用来做出关于UTI儿童管理的决定。
To identify risk factors for febrile recurrence of urinary tract infections (UTIs) in children with a history of UTI. We included 500 children 2 to 72 months of age with a history of UTI who were followed prospectively for approximately 2 years in the context of two previously conducted studies (RIVUR and CUTIE). We identified significant risk factors for febrile recurrences among children not receiving antimicrobial prophylaxis using univariate and multivariate logistic regression. On univariate analysis, non-Black race, febrile index UTI, bowel-bladder dysfunction, grade IV vesicoureteral reflux, renal scarring at baseline, and renal-bladder ultrasound abnormalities were associated with febrile recurrence. On multivariate analysis, the following variables independently increased the odds of febrile recurrences (odds ratio; 95% confidence interval): non-Black race (7.1; 1.5-127.9), bowel-bladder dysfunction (2.6; 1.1-5.3), febrile index UTI (2.5; 1.1-6.9), abnormalities on renal-bladder ultrasound (2.6; 1.2-5.6), grade IV vesicoureteral reflux (3.9; 1.4-10.5), and renal scarring at baseline (4.7; 1.2-19.1). Non-Black race and grade IV vesicoureteral reflux increased the odds of febrile recurrence of UTI. Although our findings should stimulate other studies to further explore the relationship between race and UTIs, given that the link between race and UTI recurrence is unclear, race should not be used to make decisions regarding management of children with a UTI.
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