在患有神经性膀的儿童中诊断评估和治疗尿路感染
Jacqueline G Holden1, Sowdhamini Wallace2, Pearl W Chang3
1Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Pittsburgh 4401 Penn Ave., Pittsburgh, PA, 15224, USA.
Journal of pediatric urology
|October 8, 2025
概括
患有神经性膀 (NGB) 的儿童经常接受不符合标准标准的尿路感染 (UTI) 诊断. 这凸显了诊断NGB尿路感染的挑战,以及需要更好的方法,特别是随着多药耐药生物的增加.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 患有神经性膀 (NGB) 的儿童面临更高的尿路感染 (UTI) 风险.
- 目前缺乏诊断和治疗NGB儿童尿路感染的指导方针.
- 这项研究比较了患有NGB的儿童的尿路感染表现和治疗,与患有膀外流 (VUR) 的儿童相比.
研究的目的:
- 为了比较患有NGB和VUR的儿童的尿路感染的临床表现和治疗.
- 评估符合标准化尿路感染定义 (UMPIRE) 的NGB儿童比例.
- 确定患有NGB的儿童中尿路感染的诊断和治疗挑战.
主要方法:
- 一项多中心回顾性队列研究包括18岁以下患有发烧性尿路感染的儿童.
- 在NGB的儿童和VUR的儿童中比较尿路感染症状和尿液分析.
- 评估的尿路感染诊断与UMPIRE定义的一致性 (≥100,000 CFU/mL,炎症,≥2个症状).
主要成果:
- 在患有NGB的儿童中,41.3%符合UMPIRE UTI定义.
- 与V.UR.相比,患有NGB的儿童在尿液培养中表现出多种耐药生物体 (MDRO) 的更高流行率.
- 患有NGB的儿童更有可能接受广谱抗生素.
结论:
- 大多数在ED诊断出患有发烧性尿路感染的NGB儿童不符合UMPIRE定义.
- 在NGB中,MDRO尿路感染的高率需要提高诊断准确度.
- 在患有NGB的儿童中准确诊断尿路感染仍然是一个重大的临床挑战.
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