儿童尿路感染发病率和趋势及抗生素处方：基于注册的普通实践研究（2000 年至 2020 年）。

Incidence rates and trends of childhood urinary tract infections and antibiotic prescribing: registry-based study in general practices (2000 to 2020).

机构信息

Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.

EPI-Centre, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.

出版信息

BMC Prim Care. 2022 Jul 20;23(1):177. doi: 10.1186/s12875-022-01784-x.

DOI:10.1186/s12875-022-01784-x

PMID:35858840

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9301837/

Abstract

BACKGROUND

To improve the management of childhood urinary tract infections, it is essential to understand the incidence rates, testing and treatment strategy.

METHODS

A retrospective study using data from 45 to 104 general practices (2000 to 2020) in Flanders (Belgium). We calculated the incidence rates (per 1000 person-years) of cystitis, pyelonephritis, and lab-based urine tests per age (< 2, 2-4, 5-9 and 10-18 years)) and gender in children and performed an autoregressive time-series analysis and seasonality analysis. In children with UTI, we calculated the number of lab-based urine tests and antibiotic prescriptions per person-year and performed an autoregressive time-series analysis.

RESULTS

There was a statistically significant increase in the number of UTI episodes from 2000 to 2020 in each age group (p < 0.05), except in boys 2-4 years. Overall, the change in incidence rate was low. In 2020, the incidence rates of cystitis were highest in girls 2-4 years old (40.3 /1000 person-years 95%CI 34.5-46.7) and lowest in boys 10-18 (2.6 /1000 person-years 95%CI 1.8-3.6) The incidence rates of pyelonephritis were highest in girls 2-4 years (5.5, 95%CI 3.5-8.1 /1000 person-years) and children < 2 years of age (boys: 5.4, 95%CI 3.1-8.8 and girls: 4.9, 95%CI 2.7-8.8 /1000 person-years). In children 2-10 years, there was an increase in number of lab-based urine tests per cystitis episode per year and a decrease in total number of electronic antibiotic prescriptions per cystitis episode per year, from 2000 to 2020. In children with cystitis < 10 years in 2020, 51% (95%CI 47-56%) received an electronic antibiotic prescription, of which the majority were broad-spectrum agents.

CONCLUSIONS

Over the last 21 years, there was a slight increase in the number of UTI episodes diagnosed in children in Flemish general practices, although the overall change was low. More targeted antibiotic therapy for cystitis in accordance with clinical guidelines is necessary to reduce the use of broad-spectrum agents in children below 10 years.

摘要

背景

为了改善儿童尿路感染的管理，了解发病率、检测和治疗策略至关重要。

方法

这是一项使用 2000 年至 2020 年间在佛兰德斯（比利时）的 45 至 104 家普通诊所的数据进行的回顾性研究。我们按年龄（<2 岁、2-4 岁、5-9 岁和 10-18 岁）和性别计算膀胱炎、肾盂肾炎和基于实验室的尿液检测的发病率（每 1000 人年），并进行自回归时间序列分析和季节性分析。对于患有尿路感染的儿童，我们按每人每年计算基于实验室的尿液检测和抗生素处方的数量，并进行自回归时间序列分析。

结果

除 2-4 岁男孩外，2000 年至 2020 年间，各年龄组的尿路感染发作次数均呈统计学显著增加（p<0.05）。总体而言，发病率的变化很小。2020 年，膀胱炎发病率在 2-4 岁女孩中最高（40.3/1000 人年，95%CI 34.5-46.7），在 10-18 岁男孩中最低（2.6/1000 人年，95%CI 1.8-3.6）。肾盂肾炎的发病率在 2-4 岁女孩中最高（5.5，95%CI 3.5-8.1/1000 人年）和<2 岁儿童（男孩：5.4，95%CI 3.1-8.8 和女孩：4.9，95%CI 2.7-8.8/1000 人年）。在 2-10 岁儿童中，每年膀胱炎发作的基于实验室的尿液检测次数和每年膀胱炎发作的电子抗生素处方总数均有所增加，从 2000 年至 2020 年。在 2020 年患有膀胱炎的<10 岁儿童中，51%（95%CI 47-56%）收到了电子抗生素处方，其中大部分是广谱药物。