Roman Heidi K, Chang Pearl W, Schroeder Alan R
Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, California; and
Department of Pediatrics, Lucile Packard Children's Hospital at Stanford, Palo Alto, California.
Hosp Pediatr. 2015 Jan;5(1):1-8. doi: 10.1542/hpeds.2014-0051.
To report the prevalence of bacteremia by age in a sample of infants<1 year of age with urinary tract infections (UTIs), to compare characteristics of infants with UTIs with and without bacteremia, and to describe treatment courses and 30-day outcomes in infants with UTIs with and without bacteremia.
We used a retrospective cross-sectional design to determine the prevalence of bacteremia in infants with UTIs at our institution. A double cohort design matching for age and gender was used to compare clinical characteristics and outcomes between infants with bacteremic versus nonbacteremic UTIs.
We identified 1379 UTIs, with blood cultures obtained in 52% of cases. The prevalence of bacteremia was 4.1% (95% confidence interval 3.1%-5.3%) for all UTIs and 8% (95% confidence interval 6.1%-10.2%) for UTIs in which blood culture was obtained. Fifty-five infants with bacteremic UTIs were compared with 110 infants with nonbacteremic UTIs. Except for minor differences in the urinalysis and serum band count, there were no significant differences in clinical presentation between the 2 groups. Bacteremic infants received longer parenteral treatment courses than nonbacteremic infants (mean 6.7 vs 2.4 days, P<.001). Treatment courses in the bacteremic group were variable and predicted by age but not severity of illness. No bacteremic infant had recurrent UTI or bacteremia with the same organism within 30 days of discharge.
Treatment was variable but outcomes were excellent in infants with bacteremic UTIs.
报告1岁以下患尿路感染（UTIs）婴儿样本中菌血症的年龄患病率，比较有菌血症和无菌血症的UTIs婴儿的特征，并描述有菌血症和无菌血症的UTIs婴儿的治疗过程及30天结局。
我们采用回顾性横断面设计来确定我院UTIs婴儿中菌血症的患病率。采用年龄和性别匹配的双队列设计，比较菌血症性UTIs婴儿与非菌血症性UTIs婴儿的临床特征和结局。
我们共识别出1379例UTIs，其中52%的病例进行了血培养。所有UTIs中菌血症的患病率为4.1%（95%置信区间3.1%-5.3%），进行血培养的UTIs中菌血症的患病率为8%（95%置信区间6.1%-10.2%）。55例菌血症性UTIs婴儿与110例非菌血症性UTIs婴儿进行了比较。除尿液分析和血清未成熟粒细胞计数存在微小差异外，两组临床表现无显著差异。菌血症婴儿接受的肠外治疗疗程比非菌血症婴儿长（平均6.7天对2.4天，P<0.001）。菌血症组的治疗疗程各不相同，且由年龄而非疾病严重程度预测。出院后30天内，无菌血症婴儿发生复发性UTIs或由相同病原体引起的菌血症。
菌血症性UTIs婴儿的治疗方案各不相同，但结局良好。
