Personal history and physical examinations can help to judge urinary tract infection in children aged 3 months to 5 years old

• Main Authors: Ming-Sheng Lee, 李明聲
• Other Authors: Long-Yau Lin
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/31818750952691105379

碩士 === 中山醫學大學 === 醫學研究所 === 101 === Background and objectives: Children between 3 months to 5 years old are unable to express their symptoms such as dysuria or urinary frequency compare to adults. The diagnosis of urinary tract infection (UTI) in this group of patients depends on urinary analysis and culture results. Although there are many patients who develop fever in pediatric outpatient clinic, whom should take a urinary test in common daily practice. Objective: To assess what personal history and physical examinations can eke to predict UTI in children between 3 months to 5 years old. Methods: Clinicians in outpatient service filled a medically record sheet when they suspect the patient with UTI, the record sheet was filled before the urine test results. The medical record sheets were compared to the final urinary test results for prediction of UTI. The patients were divided into two groups during analysis, which are 3 months to 2 years of age and 2 years to 5 years of age. Univariate odds ratio was done to find the possible risk factors, and these factors were then adjusted by multivariate odds ratio. Results: There were 410 patients between 3 months to 2 years old and 115 patients between 2 years to 5 years old in this study. We found that in patients between 3 months to 2 years old, the risk factors of UTI were younger age, female gender, and non-injected throat. The odds ratio (OR) among this group were decreased annually by 5.051 (P<0.001；CI：1.190-3.765), and the ORs for female gender and non-injected throat were 2.117 (P<0.05；CI：1.190-3.765), and 1.907 (P<0.05；CI：1.047-3.470), respectively. The risk of positive urinary analysis in patients between 3 months to 2 years old with diarrhea less than 3 times was higher than those with diarrhea more than 3 times, the OR was 8.80 (P<0.05；CI：1.07-72.09). The risk of UTI in patients between 2 years to 5 years old with non-injected throat was higher than those with injected throat, the OR was 3.672(P<0.05；CI：1.029-13.107). Conclusions: Young age and female gender are effective predictive factors for UTI in patients between 3 months to 2 years old. Non-injected throat is a risk factor for positive urinary analysis results among patients between 2 years to 5 years old. History taking and physical examination can help in diagnosis UTI.