Kwok Wing-Yee, de Kwaadsteniet Marjolein C E, Harmsen Mirjam, van Suijlekom-Smit Lisette W A, Schellevis François G, van der Wouden Johannes C
Department of General Practice, Erasmus MC - University Medical Center Rotterdam, PO Box 1738, 3000 DR, Rotterdam The Netherlands.
BMC Pediatr. 2006 Apr 4;6:10. doi: 10.1186/1471-2431-6-10.
We aimed to investigate incidence rates of urinary tract infections in Dutch general practice and their association with gender, season and urbanisation level, and to analyse prescription and referral in case of urinary tract infections.
During one calendar year, 195 general practitioners in 104 practices in the Netherlands registered all their patient contacts. This study was performed by the Netherlands Institute for Health Services Research (NIVEL) in 2001. Of 82,053 children aged 0 to 18 years, the following variables were collected: number of episodes per patient, number of contacts per episode, month of the year in which the diagnosis of urinary tract infection was made, age, gender, urbanisation level, drug prescription and referral.
The overall incidence rate was 19 episodes per 1000 person years. The incidence rate in girls was 8 times as high as in boys. The incidence rate in smaller cities and rural areas was 2 times as high as in the three largest cities. Throughout the year, incidence rates varied with a decrease in summertime for children at the age of 0 to 12 years. Of the prescriptions, 66% were in accordance with current guidelines, but only 18% of the children who had an indication were actually referred.
This study shows that incidence rates of urinary tract infections are not only related to gender and season, but also to urbanisation. General practitioners in the Netherlands frequently do not follow the clinical guidelines for urinary tract infections, especially with respect to referral.
我们旨在调查荷兰全科医疗中尿路感染的发病率及其与性别、季节和城市化水平的关联，并分析尿路感染时的处方和转诊情况。
在一个日历年内，荷兰104家诊所的195名全科医生记录了他们所有的患者接触情况。这项研究由荷兰卫生服务研究机构（NIVEL）于2001年进行。在82053名0至18岁的儿童中，收集了以下变量：每位患者的发作次数、每次发作的接触次数、做出尿路感染诊断的月份、年龄、性别、城市化水平、药物处方和转诊情况。
总体发病率为每1000人年19次发作。女孩的发病率是男孩的8倍。小城市和农村地区的发病率是三大城市的2倍。全年中，0至12岁儿童的发病率在夏季有所下降。在处方中，66%符合现行指南，但有转诊指征的儿童中只有18%实际被转诊。
本研究表明，尿路感染的发病率不仅与性别和季节有关，还与城市化有关。荷兰的全科医生经常不遵循尿路感染的临床指南，尤其是在转诊方面。
