Bahat Hilla, Apelman Cipele Revital, Maymon Tali, Youngster Ilan, Goldman Michael
Department of Pediatrics, Shamir Medical Center, Zerifin, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Front Pediatr. 2021 Nov 1;9:762577. doi: 10.3389/fped.2021.762577. eCollection 2021.
A correct diagnosis of urinary tract infection in young infants requires an uncontaminated urine culture, commonly obtained by urethral catheterization. In the current study, we examined the rates and factors associated with contaminations of catheter-obtained urine cultures in very young infants. This prospective cohort study included 143 catheter-obtained urine cultures of infants ≤2 months of age admitted to the pediatric ward of a tertiary hospital in Israel from April 2019 to September 2020. Patient's and operator's study variables were documented at the time of catheter insertion. Positive urine cultures were reviewed by a pediatric nephrologist and a pediatric infectious disease specialist and designated as infection or contamination. The study variables were compared between those with or without contamination. The contamination rate in our cohort was 29%. Females were more than twice as likely to have a contaminated urine culture (37 vs. 18%, respectively, = 0.014). Circumcision status, official training about sterile catheterization, a sense of difficult catheterization, and the shift in which the culture was obtained did not influence the contamination rate. Catheter-obtained urine cultures have a high contamination rate among very young infants, especially among girls.
对幼儿尿路感染进行正确诊断需要进行无污染的尿培养，通常通过尿道插管获取。在本研究中，我们调查了极幼龄婴儿通过插管获取的尿培养污染率及相关因素。这项前瞻性队列研究纳入了2019年4月至2020年9月在以色列一家三级医院儿科病房住院的143例≤2月龄婴儿通过插管获取的尿培养。在插管时记录患者和操作者的研究变量。阳性尿培养由儿科肾病学家和儿科传染病专家复查，并判定为感染或污染。对有污染和无污染的研究变量进行比较。我们队列中的污染率为29%。女性尿培养污染的可能性是男性的两倍多（分别为37%和18%，P = 0.014）。包皮环切状态、无菌插管的正规培训、插管困难感以及获取培养的班次均不影响污染率。在极幼龄婴儿中，尤其是女孩中，通过插管获取的尿培养污染率很高。
