儿科泌尿道感染(英文PPT)Pediatrics-Urinary-Tract-Infections课件.ppt

1、Demographic groupPrevalence (pretest probability)OddsCircumcised boys 1 yr1 percent.01 (1 in 100)Circumcised boys 1 yr2 percent.02 (1 in 50)Black girls4 percent.04 (1 in 25)Uncircumcised boys 2 yr8 percent.09 (1 in 12)White girls 2 yr16 percent.19 (1 in 5)Data from:Hoberman, A, Chao, HP, Keller, DM,

2、 et al. Prevalence of urinary tract infection in febrile infants. J Pediatr 1993; 123:17.Shaw, KN, Gorelick, M, McGowan, KL, et al. Prevalence of urinary tract infection in febrile young children in the emergency department. Pediatrics 1998; 102:e16.Method of urine collectionDiagnostic thresholdClea

3、n-catch in voiding girls100,000 CFU per mL10,000 100,000 repeat cultureClean-catch in voiding boys10,000 CFU per mLCatheter10,000 CFU1,000 10,000 repeat cultureSuprapubic aspirationAny colonies of GNRsMore than a few thousand GPCsHillerstein S. Recurrent urinary tract infections in children. Pediatr

4、 Infect Dis 1982; 1:275.Hoberman A, Wald ER, Hickey RW, Baskin M, Charron M, Majd M, et al. Oral versus initial intravenous therapy for urinary tract infections in young febrile children. Pediatrics 1999;104:79-86.Baker PC, Nelson DS, Schunk JE. The addition of ceftriaxone to oral therapy does not i

5、mprove outcome in febrile children with urinary tract infections. Arch Pediatr Adolesc Med 2001;155:135-9.Committee on Quality Improvement, Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants

6、and young children. published corrections appear in Pediatrics 2000;105:141, 1999;103:1052, and 1999;104:118. Pediatrics 1999;103:843-52.Zamir G, Sakran W, Horowitz Y, Koren A, Miron D. Urinary tract infection: is there a need for routine renal ultrasonography? Arch Dis Child 2004;89:466-8Dick PT. A

7、nnual Meeting of Canadian Pediatric Society, June 12-16, 2002. Pediatric Notes 2002;26(27):105Nuutinen M, Uhari M. Recurrence and follow-up after urinary tract infection under the age of 1 year. Pediatr Nephrol 2001;16:69-72Cooper CS, et al. The outcome of stopping prophylactic antibiotics in older

8、children with vesicoureteral reflux. J Urol 2000 Jan;163(1):269-72; discussion 272-3. Up To Date accessed September 12, 2007Elder JS, et al. Pediatric Vesicoureteral Reflux Guidelines Panel summary report on the management of primary vesicoureteral reflux in children, J Urol 1997 May;157(5):1846-51.