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新生儿和小婴儿尿路感染经验性治疗的疗效

Efficacy of Empiric Treatment of Urinary Tract Infections in Neonates and Young Infants.

作者信息

Antoon James W, Reilly Paige J, Munns Erin H, Schwartz Alan, Lohr Jacob A

机构信息

University of Illinois at Chicago College of Medicine, IL, USA.

University of North Carolina at Chapel Hill School of Medicine, NC, USA.

出版信息

Glob Pediatr Health. 2019 Jun 19;6:2333794X19857999. doi: 10.1177/2333794X19857999. eCollection 2019.

Abstract

. The antibiotic resistance patterns of young infants with urinary tract infections (UTIs) have evolved over the past 2 decades. Whether current empiric antibiotic regimens are sufficient in this age group is unknown. . A retrospective review of patients aged 0 to 60 days admitted with a UTI discharge diagnosis. . Overall susceptibility to empiric antibiotics was 87%. Antibiotic resistance and length of stay were highest among those who were afebrile, those admitted to the intensive care unit, and those with culture diagnosis of enterococcal infection. The sensitivity and specificity of ultrasound as a screening tool for genitourinary anomaly was 70% and 40%, respectively, with a positive predictive value of 31.8%. . Empiric antibiotic regimens cover a high percentage of UTIs in infants. However, high rates of resistance and prolonged length of stay in patients with enterococcal infection highlight the need for continued surveillance of such patients in this age group.

摘要

在过去20年中,患有尿路感染(UTIs)的婴幼儿的抗生素耐药模式已经发生了演变。目前的经验性抗生素治疗方案在这个年龄组中是否足够尚不清楚。对出院诊断为UTIs的0至60天龄患者进行回顾性研究。经验性抗生素的总体敏感性为87%。在无发热患者、入住重症监护病房的患者以及培养诊断为肠球菌感染的患者中,抗生素耐药性和住院时间最长。超声作为泌尿生殖系统异常筛查工具的敏感性和特异性分别为70%和40%,阳性预测值为31.8%。经验性抗生素治疗方案覆盖了婴儿中很大比例的UTIs。然而,肠球菌感染患者的高耐药率和延长的住院时间凸显了对这个年龄组此类患者持续监测的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d30/6587387/a06723a1e661/10.1177_2333794X19857999-fig1.jpg

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