文献詳細
特集 デキル内科医のコンサルト—専門医が教える隠れたエッセンス
コンサルトを依頼する
文献概要
Point
◎乳幼児の熱源不明の発熱では尿路感染症(UTI)を必ず鑑別に挙げる.特に咽頭発赤がない場合は,注意が必要である.
◎尿培養は,クリーン・キャッチもしくは導尿で確保した尿を提出する.
◎バッグ尿で尿培養を提出すると,コンタミネーションの確率が高い.
◎抗菌薬投与前には必ず血液培養も提出する.
◎乳幼児の熱源不明の発熱では尿路感染症(UTI)を必ず鑑別に挙げる.特に咽頭発赤がない場合は,注意が必要である.
◎尿培養は,クリーン・キャッチもしくは導尿で確保した尿を提出する.
◎バッグ尿で尿培養を提出すると,コンタミネーションの確率が高い.
◎抗菌薬投与前には必ず血液培養も提出する.
参考文献
1)Roberts KB:Urinary tract infection;Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 128:595-610, 2011
2)Wang PY, et al:Personal history and physical examination in judgment of urinary tract infection in children aged 3 months to 2 years. Pediatr Neonatol 57:274-279, 2016
3)Kaufman J, et al:Urinary tract infections in children;An overview of diagnosis and management. BMJ paediatrics open 3:e000487, 2019 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6782125/(2020年2月閲覧)
4)Lavelle JM, et al:Two-step process for ED UTI screening in febrile young children;Reducing catheterization rates. Pediatrics 138, 2016 https://pediatrics.aappublications.org/content/pediatrics/138/1/e20153023.full.pdf(2020年2月閲覧)
5)Williams GJ, et al. Absolute and relative accuracy of rapid urine tests for urinary tract infection in children;A meta-analysis. Lancet Infect Dis 10:240-50, 2010
6)Yodoshi T, et al:Utility of point-of-care Gram stain by physicians for urinary tract infection in children ≦36 months. Medicine(Baltimore)98:e15101, 2019 https://insights.ovid.com/crossref?an=00005792-201904050-00065(2020年2月閲覧)
7)Tosif S, et al:Contamination rates of different urine collection methods for the diagnosis of urinary tract infections in young children;An observational cohort study. Journal of paediatrics and child health 48:659-664, 2012
8)Edlin RS, et al:Antibiotic resistance patterns of outpatient pediatric urinary tract infections. The Journal of urology 190:222-227, 2013
9)Roman HK, et al:Diagnosis and management of bacteremic urinary tract infection in infants. Hospital pediatrics 5:1-8, 2015
10)Cruz C, Spina L:Are oral antibiotics as effective as a combination of intravenous and oral antibiotics for kidney infections in children? Ann Emerg Med 67:30-31, 2016
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