Sutton Ashley G, Chandler Nicole, Roberts Kenneth B
Department of Pediatrics, University of North Carolina School of Medicine, 101 Manning Drive, CB # 7220, Chapel Hill, NC, 27514. United States.
Cone Health, Pediatric Teaching Service, Greensboro, NC, USA.
Rev Recent Clin Trials. 2017;12(4):269-276. doi: 10.2174/1574887112666170816143639.
Urinary Tract Infection (UTI) is a common cause of bacterial infection in young children, and accounts for a significant number of pediatric hospitalizations.
To review recent publications focusing on the care of children hospitalized with their first febrile UTI.
A PubMed search was performed including publications from 2011-2016 on first febrile UTI in childhood. Abstracts were reviewed for being relevant to the care of hospitalized children and their follow-up. Relevant articles underwent full review by all authors and articles excluded from results included those without novel data analysis, primary improvement-based reports and studies with poor design or analysis. Included articles were categorized as "diagnosis", "management", "imaging" or "follow-up".
Of 406 articles initially identified, 40 studies were included. One technical report with a systematic review was also included. Major topics addressed included the role of urinalysis in screening for UTI, use of parenteral antimicrobial therapy, the role of antimicrobial prophylaxis in prevention of recurrent UTI, and ideal follow-up and imaging approach following diagnosis of febrile UTI.
Recent literature on first febrile UTI addresses a broad range of areas regarding the care of hospitalized children, though some questions remain unanswered. Overall, studies support increased attention to the potential risks, expense and invasiveness of various approaches for evaluation. Proposed updates to practice included: utilization of urinalysis for screening and diagnosis, transitioning to oral antimicrobials based on clinical improvement and limiting the routine use of voiding cystourethrogram and antimicrobial prophylaxis.
尿路感染（UTI）是幼儿细菌感染的常见原因，占儿科住院病例的很大比例。
回顾近期关于首次发热性尿路感染住院儿童护理的出版物。
进行PubMed检索，纳入2011年至2016年关于儿童首次发热性尿路感染的出版物。对摘要进行审查，以确定其与住院儿童护理及其随访的相关性。所有作者对相关文章进行全文审查，排除结果中的文章包括那些没有新颖数据分析、基于主要改进的报告以及设计或分析不佳的研究。纳入的文章分为“诊断”、“管理”、“影像学”或“随访”类别。
最初识别出406篇文章，纳入了40项研究。还纳入了一篇带有系统评价的技术报告。涉及的主要主题包括尿液分析在尿路感染筛查中的作用、肠外抗菌治疗的使用、抗菌预防在预防复发性尿路感染中的作用以及发热性尿路感染诊断后的理想随访和影像学方法。
近期关于首次发热性尿路感染的文献涉及住院儿童护理的广泛领域，尽管一些问题仍未得到解答。总体而言，研究支持更多关注各种评估方法的潜在风险、费用和侵入性。提议的实践更新包括：利用尿液分析进行筛查和诊断，根据临床改善情况过渡到口服抗菌药物，并限制排尿性膀胱尿道造影和抗菌预防的常规使用。
