Liu Kang, Tseng Chi-Shin, Wong Shin-Mei, Huang Kuo-How, Chiang I-Ni, Huang Chao-Yuan, Chiang Chih-Hung
Department of Education, National Taiwan University Hospital, National Taiwan University, Taipei 100229, Taiwan.
Department of Urology, National Taiwan University Hospital, National Taiwan University, Taipei 100229, Taiwan.
Biomedicines. 2024 Dec 17;12(12):2866. doi: 10.3390/biomedicines12122866.
: We aimed to determine the proportion of bacterial etiology in pediatric acute epididymitis (AE) and to compare the predictive accuracy of C-reactive protein (CRP) and urinalysis. : Pediatric patients diagnosed with AE in National Taiwan University Hospital from 2009 to 2018 were retrospectively identified. Patient profiles, including clinical symptoms, physical findings, laboratory data, and treatment types, were collected. Patients were categorized into acute bacterial epididymitis (ABE) or acute non-bacterial epididymitis (ANBE) groups based on the presence or absence of bacterial growth in urine cultures. The primary endpoints were the proportion of patients with ABE and those who received antibiotic therapy. The secondary endpoint was to assess the diagnostic accuracy of CRP and urinalysis for ABE. : The final cohort comprised of 289 patients, of whom 216 (74.7%) received antibiotics. Urine culture was obtained for 167 (57.8%) patients, and 52 (31.1%) were positive for a bacterial source. The median CRP and positive rate for urinalysis were significantly higher in the ABE group compared to the ANBE group (CRP: 3.68 vs. 0.25 mg/dL; < 0.001; urinalysis: 41% vs. 23%; = 0.005). Multivariate analysis revealed that elevated CRP was significantly associated with AE (odds ratio [OR], 61.96; < 0.001), whereas positive urinalysis was not (OR, 2.09; = 0.33). The area under the receiver operating characteristic curves for CRP was higher than that for urinalysis (0.82 vs. 0.72). : Serum CRP proved to be a more accurate and reliable tool than urinalysis for predicting pediatric ABE. This could provide guidance to practitioners when prescribing antibiotics in the future.
我们旨在确定小儿急性附睾炎（AE）的细菌病因比例，并比较C反应蛋白（CRP）和尿液分析的预测准确性。回顾性确定2009年至2018年在台湾大学医院诊断为AE的儿科患者。收集患者资料，包括临床症状、体格检查结果、实验室数据和治疗类型。根据尿培养中是否有细菌生长，将患者分为急性细菌性附睾炎（ABE）或急性非细菌性附睾炎（ANBE）组。主要终点是ABE患者的比例和接受抗生素治疗的患者比例。次要终点是评估CRP和尿液分析对ABE的诊断准确性。最终队列包括289名患者，其中216名（74.7%）接受了抗生素治疗。167名（57.8%）患者进行了尿培养，52名（31.1%）细菌来源呈阳性。与ANBE组相比，ABE组的CRP中位数和尿液分析阳性率显著更高（CRP：3.68 vs. 0.25 mg/dL；<0.001；尿液分析：41% vs. 23%；=0.005）。多变量分析显示，CRP升高与AE显著相关（比值比[OR]，61.96；<0.001），而尿液分析阳性则不然（OR，2.09；=0.33）。CRP的受试者工作特征曲线下面积高于尿液分析（0.82 vs. 0.72）。血清CRP被证明是比尿液分析更准确、更可靠的预测小儿ABE的工具。这可为从业者未来开具抗生素时提供指导。
