早产儿尿路感染：定义难题。
Urinary tract infections in very premature neonates: the definition dilemma.
机构信息
Department of Pediatrics, Division of Neonatology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.
Department of Pediatrics, Division of Infectious Diseases, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada.
出版信息
J Perinatol. 2024 May;44(5):731-738. doi: 10.1038/s41372-024-01951-1. Epub 2024 Mar 29.
BACKGROUND AND OBJECTIVES
Data on urinary tract infections (UTIs) in very preterm neonates (VPTNs) are scarce. We aimed to (i) describe the characteristics of UTIs in VPTNs and (ii) compare the diagnostic practices of neonatal clinicians to established pediatric guidelines.
METHODS
All VPTNs (<29 weeks GA) with a suspected UTI at the CHU Sainte-Justine neonatal intensive care unit from January 1, 2014, and December 31, 2019, were included and divided into two definition categories: Possible UTI, and Definite UTI.
RESULTS
Most episodes were Possible UTI (87%). Symptoms of UTIs and pathogens varied based on the definition category. A positive urinalysis was obtained in 25%. Possible UTI episodes grew 2 organisms in 62% of cases and <50,000 CFU/mL in 62% of cases.
CONCLUSION
Characteristics of UTIs in VPTNs vary based on the definition category and case definitions used by clinicians differ from that of established pediatric guidelines.
背景与目的
关于极低出生体重儿（VPTN）尿路感染（UTI）的数据很少。我们旨在：（i）描述 VPTN 中 UTI 的特征；（ii）比较新生儿临床医生的诊断实践与既定儿科指南。
方法
2014 年 1 月 1 日至 2019 年 12 月 31 日，在圣贾斯汀大学医院新生儿重症监护病房（NICU）疑似 UTI 的所有 VPTN（<29 周 GA）均被纳入，并分为两个定义类别：可能的 UTI 和明确的 UTI。
结果
大多数病例为可能的 UTI（87%）。UTI 的症状和病原体因定义类别而异。尿液分析呈阳性的占 25%。可能的 UTI 发作中有 62%的病例培养出 2 种病原体，且<50,000 CFU/mL 的占 62%。
结论
VPTN 中 UTI 的特征因定义类别而异，临床医生使用的病例定义与既定儿科指南不同。
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