Belleau C, Grimaud C, Pillet P, Bailhache M
Pôle de pédiatrie, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France.
Pôle de pédiatrie, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France; Centre Inserm U1219 Bordeaux Population Health, université de Bordeaux, ISPED, 146, rue Léo-Saignat, 33000 Bordeaux, France.
Arch Pediatr. 2019 Sep;26(6):313-319. doi: 10.1016/j.arcped.2019.05.016. Epub 2019 Jul 26.
Management of febrile infants is challenging due to the increased risk of serious bacterial infections and it varies among physicians and hospitals. The goals of this study were to describe and compare the management of febrile infants aged 1-2 months in a hospital in 2011 and 2016.
We conducted a retrospective study in the Bordeaux Pellegrin University Hospital, France, in 2011 and 2016. All infants aged 1-2 months with diagnosis codes referring to fever were included. Data on infant characteristics, fever episodes, clinical symptoms, and management were collected from medical charts. Univariate analyses and multivariate logistic models were used.
A total of 530 infants were included; 89.2% had blood testing and 81.1% urine testing; 79.6% of the infants were hospitalized, three of them in the pediatric intensive care unit. The median hospitalization duration was 3 days. In the sample investigated, 59.8% of the infants received antibiotic therapy and 128 (24.1%) had bacterial infections with no difference between 2011 and 2016. The main bacterial infection was pyelonephritis (86.7%). Urethral catheterization was implemented in 2016, whereas a urine bag was utilized for 174 out of 177 infants in 2011. The percentage of contaminated urine cultures was higher in 2011 (35.9%) than in 2016 (19.6%, P<0.001). The hospitalization rate was higher in 2016.
Management of febrile infants changed between 2011 and 2016. The hospitalization rate and antibiotic therapy use remained high regarding the rate of bacterial infection. Use of urethral catheterization decreased the level of contamination.
由于严重细菌感染风险增加，发热婴儿的管理具有挑战性，且不同医生和医院的管理方式存在差异。本研究的目的是描述和比较2011年和2016年一家医院中1至2个月大发热婴儿的管理情况。
我们于2011年和2016年在法国波尔多佩勒格林大学医院进行了一项回顾性研究。纳入所有诊断编码涉及发热的1至2个月大婴儿。从病历中收集婴儿特征、发热发作、临床症状和管理方面的数据。采用单因素分析和多因素逻辑模型。
共纳入530名婴儿；89.2%进行了血液检测，81.1%进行了尿液检测；79.6%的婴儿住院，其中3名入住儿科重症监护病房。中位住院时间为3天。在调查样本中，59.8%的婴儿接受了抗生素治疗，128名（24.1%）患有细菌感染，2011年和2016年之间无差异。主要细菌感染为肾盂肾炎（86.7%）。2016年实施了尿道插管，而2011年177名婴儿中有174名使用了尿袋。2011年尿液培养污染的百分比（35.9%）高于2016年（19.6%，P<0.001）。2016年住院率更高。
2011年至2016年期间，发热婴儿的管理发生了变化。就细菌感染率而言，住院率和抗生素治疗使用率仍然很高。尿道插管的使用降低了污染水平。
