在儿科发烧性尿路感染中优化风险分层:日本的一项单中心研究
Tomohiro Inoguchi1,2, Riku Hamada1,2, Yooka Nam1
1Department of Nephrology and Rheumatology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
PloS one
|November 3, 2025
概括
识别非大肠杆菌感染和异常的脏膀超声波可以预测东亚儿童发烧性尿路感染 (f-UTI) 的干预需要. 这有助于更好的风险分层和有针对性的成像.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 儿童发烧性尿路感染 (f-UTI) 可能导致脏痕,需要有效的风险分层进行及时干预.
- 目前f-UTI成像指南主要基于西方人口,可能无法准确预测东亚儿童的干预需求.
- 预测哪些孩子需要治疗干预对于预防长期并发症至关重要.
研究的目的:
- 为东亚儿童建立风险分层标准,这些儿童经历了第一次f-UTI.
- 确定在这个儿科群体中需要治疗干预的特定预测因素.
- 加强关于东亚儿童f-UTI成像和管理的临床决策.
主要方法:
- 一项回顾性单中心研究分析了216名2-24个月龄的儿童,他们患有第一个f-UTI.
- 患者接受了标准化 - 膀超声波 (KBUS) 和空白囊回形图 (VCUG).
- 多变量逻辑回归确定了主要结果的独立预测因素:治疗干预的要求 (泌尿外科手术,抗微生物预防或治疗复发性f-UTI).
主要成果:
- 在216名患者中,59名患者需要治疗干预.
- 非大肠杆菌感染 (OR 3.3) 和异常KBUS发现 (OR 5.3) 被确定为需要干预的独立预测因素.
- 鉴定到的预测因素显示,预测治疗干预的需要的灵敏度为64.4%,特异性为73.2%.
结论:
- 非大肠杆菌感染和异常KBUS发现是需要治疗干预措施的重要预测因子,东亚儿童与第一次f-UTI.
- 这些预测因素可以帮助优化风险分层和患者选择VCUG,提高诊断准确度.
- 使用这些因素的有针对性的方法可以在这个人口群体中更有效地管理f-UTI.
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