婴儿同时患有细菌性脑膜炎和尿路感染:系统性审查和元分析
Jian Yi Soh1,2, Fang Ni Ting1,2, Miny Samuel3
1Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
Singapore medical journal
|August 13, 2025
概括
发烧的婴儿有尿路感染 (UTI) 很少有细菌性脑膜炎. 对于没有脑膜炎症状的看起来健康的婴儿,建议在完整的败血检查期间进行查性尿液检查.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 基于证据的医学基于证据的医学.
背景情况:
- 尿路感染 (UTI) 是发烧的婴儿中最常见的严重细菌感染.
- 污水处理是标准的,但腰部穿刺实践和脑膜炎的发病率各不相同.
- 这项研究解决了与UTI发烧的婴儿同时发生细菌性脑膜炎的不确定性.
研究的目的:
- 系统地审查和元分析被诊断患有尿路感染的发烧婴儿细菌脑膜炎的发病率.
- 为临床实践提供有关发烧婴儿诊断工作的信息.
主要方法:
- 观察性研究的系统审查和元分析 (开始至2023年8月).
- 包括发烧的婴儿 ≤90天与尿路感染和没有明确的来源;不包括那些局部症状或早产.
- 使用随机效应模型合成数据;通过纽卡斯尔-太华尺度评估研究质量.
主要成果:
- 分析了39项涉及患有尿路感染的发烧婴儿的研究.
- 细菌性脑膜炎的患病率很低,为0.3% (95% CI 0.1%-0.4%).
- 新生儿 (0.7%) 与老年婴儿 (0.2%) 的比率更高,尽管在研究中的比较显示没有差异. 脑膜炎和细菌病之间没有发现任何联系.
结论:
- 没有脑膜炎症状的临床上良好发烧的婴儿应该有一个查尿样.
- 对于所有患有尿路感染的发烧婴儿,可能不需要进行常规的全检查.
- 这支持了更有针对性的诊断方法,可能减少不必要的侵入性手术.
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