发热时间长短影响婴幼儿尿袋分析或导管培养阳性的可能性。

Duration of fever affects the likelihood of a positive bag urinalysis or catheter culture in young children.

机构信息

Department of Emergency Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.

出版信息

J Pediatr. 2010 Apr;156(4):629-33. doi: 10.1016/j.jpeds.2009.10.016. Epub 2009 Dec 21.

DOI:10.1016/j.jpeds.2009.10.016

PMID:20022342

Abstract

OBJECTIVE

To test the hypothesis that there will be a clinically significant rise in the proportion of positive bag urinalyses and catheter cultures in young children with increasing duration of fever.

STUDY DESIGN

This was a prospective cohort study of 818 infants and children age 3-36 months presenting to a tertiary care emergency department with documented fever without source. Following the documentation of fever from < 1 to > or = 5 days, bag specimens were collected for urinalysis. The primary outcome was the yield of positive bag dipsticks by day, defined as positive for nitrates or more than trace leukocyte esterase. The secondary outcome was positive catheter cultures on each day of fever.

RESULTS

Positive bag urinalyses increased with duration of fever: 14.8% (35/237) on day 1 versus 26.4% (43/163) on day 3 (relative risk [RR] = 1.8; 95% confidence interval [CI] = 1.2-2.7; P = .004). Positive catheter cultures increased in the same fashion: 4.8% (11/229) on day 1 versus 12.6% (20/159) on day 3 (RR = 2.6; 95% CI = 1.3-5.3; P = .005).

CONCLUSIONS

The yield of positive bag urinalyses and catheter cultures increased significantly in children with fever of 3 days or longer duration.

摘要

目的

检验如下假设，即发热时间延长会导致小儿（3-36 月龄）的尿袋尿液分析和导尿管培养阳性的比例出现临床显著升高。

研究设计

这是一项对 818 例发热无明确病因的 3-36 月龄婴幼儿进行的前瞻性队列研究。在发热记录时间<1 天至>或=5 天之间，收集尿袋标本进行尿液分析。主要转归指标为每日尿袋检测阳性率，定义为硝酸盐阳性或白细胞酯酶阳性超过痕迹。次要转归指标为发热期间每日的导尿管培养阳性率。

结果

阳性尿袋检测率随发热时间延长而升高：第 1 天为 14.8%（35/237），第 3 天为 26.4%（43/163）（相对风险 [RR] = 1.8；95%置信区间 [CI] = 1.2-2.7；P =.004）。阳性导尿管培养率也呈同样趋势升高：第 1 天为 4.8%（11/229），第 3 天为 12.6%（20/159）（RR = 2.6；95% CI = 1.3-5.3；P =.005）。