Harmsen Mirjam, Wolters René J, van der Wouden Johannes C, Grol Richard P T M, Wensing Michel
Radboud Univeristy Nijmegen Medical Centre, Scientific Institute for Qualty of Healthcare, Nijmegen, the Netherlands.
J Eval Clin Pract. 2009 Jun;15(3):464-7. doi: 10.1111/j.1365-2753.2008.01037.x. Epub 2009 Apr 2.
To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice.
Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed as having a UTI. A total of 49 general practices participated in the study, and provided information on 148 children aged 0-12 years old.
The nitrite test, which is recommended as first step, was performed in 87% of the children during the first contact. Less than 30% of the children had a dipslide and 37% a cultured urine. About half of all children with a UTI diagnosis had a follow-up contact in general practice, and an average of 83% of these children had their urine tested. The recommended test, a dipslide, was performed in 26% of the children with a follow-up contact. Patient age and UTI history were associated with choice of test.
The diagnostic procedures for UTIs in children in general practices could be improved, with focus on the importance of an accurate UTI diagnosis in all children, and explaining which tests should be performed and what the test results mean.
研究全科医生用于诊断儿童尿路感染（UTI）的检测方法，以及哪些患者特征与检测方法的选择相关。
对荷兰全科医疗中被诊断为UTI的儿童进行UTI诊断的回顾性病历审查。共有49家全科诊所参与了该研究，并提供了148名0至12岁儿童的信息。
作为第一步推荐的亚硝酸盐检测，在初次就诊时87%的儿童中进行了该项检测。不到30%的儿童进行了尿试纸检测，37%的儿童进行了尿培养。所有被诊断为UTI的儿童中约有一半在全科医疗中进行了随访，这些儿童中平均83%进行了尿液检测。推荐的检测方法，即尿试纸检测，在进行随访的儿童中26%进行了该项检测。患者年龄和UTI病史与检测方法的选择相关。
全科医疗中儿童UTI的诊断程序可以改进，重点是在所有儿童中准确诊断UTI的重要性，并解释应进行哪些检测以及检测结果的意义。
