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儿童排尿性膀胱尿道造影术后培养阳性的尿路感染

Culture-positive urinary tract infection following micturating cystourethrogram in children.

作者信息

Ngweso Simeon, Nyandoro Munyaradzi, Nzenza Tatenda, Cheow Ting Yi, Bettenay Fiona, Barker Andrew, Khosa Japinder, Samnakay Naeem

机构信息

Fiona Stanley Hospital. Murdoch, Western Australia, Australia.

Young Urology Researchers Organisation, Melbourne, Australia.

出版信息

Asian J Urol. 2022 Jul;9(3):329-333. doi: 10.1016/j.ajur.2021.08.006. Epub 2021 Aug 26.

Abstract

OBJECTIVE

To determine the incidence of culture-positive urinary tract infection (UTI) after micturating cystourethrogram (MCUG). We further wanted to identify risk factors for developing a culture-positive UTI following MCUG.

METHODS

A retrospective review of the available medical records of 500 paediatric patients who underwent MCUG in Perth, Western Australia was performed.

RESULTS

Seven (1.4%) patients comprised of four females and three males developed a febrile, culture-positive UTI within 14 days following MCUG. Significant association was found for female patients, patients with neurogenic bladder, and patients with previous culture-positive UTI as developing a culture-positive UTI following MCUG. Multivariate logistic regression determined that patients were more likely to develop culture-positive UTI within 14 days following MCUG if they had a known history of UTI (odds ratio: 5.0, 95% confidence interval: 1.5-17.3, =0.010) or had a neurogenic bladder (odds ratio: 4.2, 95% confidence interval: 1.0-17.9, =0.049).

CONCLUSION

The incidence of patients who developed a febrile, culture-positive UTI following MCUG was low at 1.4%. Statistically significant and independent associations for the development of culture positive UTI were found in patients with neurogenic bladder and patients with previous culture-positive UTI. Further prospective studies are necessary to determine necessity of prophylactic antibiotics for high-risk patients, , patients with neurogenic bladder or previous culture-positive UTI.

摘要

目的

确定排尿性膀胱尿道造影(MCUG)后培养阳性的尿路感染(UTI)的发生率。我们还想确定MCUG后发生培养阳性UTI的危险因素。

方法

对在澳大利亚西部珀斯接受MCUG的500例儿科患者的现有病历进行回顾性研究。

结果

7例(1.4%)患者(4例女性和3例男性)在MCUG后14天内发生了发热性、培养阳性的UTI。发现女性患者、神经源性膀胱患者以及既往有培养阳性UTI的患者在MCUG后发生培养阳性UTI的相关性显著。多因素logistic回归分析确定,有UTI已知病史(比值比:5.0,95%置信区间:1.5 - 17.3,P = 0.010)或有神经源性膀胱(比值比:4.2,95%置信区间:1.0 - 17.9,P = 0.049)的患者在MCUG后14天内更有可能发生培养阳性的UTI。

结论

MCUG后发生发热性、培养阳性UTI的患者发生率较低,为1.4%。在神经源性膀胱患者和既往有培养阳性UTI的患者中发现了培养阳性UTI发生的统计学显著且独立的相关性。需要进一步的前瞻性研究来确定高危患者(即神经源性膀胱患者或既往有培养阳性UTI的患者)预防性使用抗生素的必要性。

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本文引用的文献

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Urinary tract infection after voiding cystourethrogram.排尿性膀胱尿道造影术后尿路感染
J Pediatr Urol. 2017 Aug;13(4):384.e1-384.e7. doi: 10.1016/j.jpurol.2017.04.018. Epub 2017 May 25.
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Urinary tract infection in the neurogenic bladder.神经源性膀胱中的尿路感染
Transl Androl Urol. 2016 Feb;5(1):72-87. doi: 10.3978/j.issn.2223-4683.2016.01.06.

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