Abstract：
BACKGROUND: The diagnosis of urinary tract infection (UTI) in the pediatric field remains a topic of debate. In 2011, the American Academy of Pediatrics (AAP) introduced new guidelines for the diagnosis of UTI in patients 2-24 months old. However, concerns were raised regarding these guidelines.
METHODS: This is a retrospective data extraction study that included patients 0-6 months of age who were examined in the pediatric emergency department between 2016 and 2021 and had a urine culture. For each patient, we recorded the diagnosis documented in the medical records, the diagnosis based on the AAP and Israeli guidelines, and the diagnosis according to our 2 proposed protocols. We then compared the percentage of UTI diagnoses according to each diagnostic guideline.
RESULTS: A total of 1432 patients under the age of 6 months underwent urine culture testing during the study period. A total of 83 (5.81%) of these patients were diagnosed with UTI according to the AAP guidelines, 184 of the patients (12.8%) were diagnosed with UTI according to the Israeli guidelines, 102 (7.1%) and 109 (7.6%) of the patients were diagnosed with UTI according to our first and second proposed guidelines, respectively.
CONCLUSIONS: We propose a new diagnostic method (guidelines II) that is suitable for patients older than 2 months, with obligatory criteria of abnormal urine test and a lower threshold for the colony count required for diagnosis compared to the AAP guidelines. Further research is required to examine the sensitivity and specificity of our proposed guidelines, so it may replace the current diverse guidelines.
METHODS: This is a retrospective data extraction study that included patients 0-6 months of age who were examined in the pediatric emergency department between 2016 and 2021 and had a urine culture. For each patient, we recorded the diagnosis documented in the medical records, the diagnosis based on the AAP and Israeli guidelines, and the diagnosis according to our 2 proposed protocols. We then compared the percentage of UTI diagnoses according to each diagnostic guideline.
RESULTS: A total of 1432 patients under the age of 6 months underwent urine culture testing during the study period. A total of 83 (5.81%) of these patients were diagnosed with UTI according to the AAP guidelines, 184 of the patients (12.8%) were diagnosed with UTI according to the Israeli guidelines, 102 (7.1%) and 109 (7.6%) of the patients were diagnosed with UTI according to our first and second proposed guidelines, respectively.
CONCLUSIONS: We propose a new diagnostic method (guidelines II) that is suitable for patients older than 2 months, with obligatory criteria of abnormal urine test and a lower threshold for the colony count required for diagnosis compared to the AAP guidelines. Further research is required to examine the sensitivity and specificity of our proposed guidelines, so it may replace the current diverse guidelines.
摘要：
背景：儿科领域尿路感染（UTI）的诊断仍然是一个争论的话题。2011年，美国儿科学会（AAP）为2-24个月大的患者引入了诊断UTI的新指南。然而,有人对这些准则表示关切。
方法：这是一项回顾性数据提取研究，包括2016年至2021年在儿科急诊科接受检查并进行尿培养的0-6个月大的患者。对于每个病人来说,我们把诊断记录在病历上,基于AAP和以色列指南的诊断，并根据我们提出的2个方案进行诊断。然后，我们根据每个诊断指南比较了UTI诊断的百分比。
结果：在研究期间，共有1432例6月龄以下的患者接受了尿培养检测。根据AAP指南，这些患者中共有83例（5.81％）被诊断为UTI，根据以色列指南，184名患者（12.8%）被诊断为UTI，102（7.1%）和109（7.6%）的患者被诊断为UTI根据我们的第一个和第二个建议的指南，分别。
结论：我们提出了一种新的诊断方法（指南II），适用于2个月以上的患者，与AAP指南相比，具有强制性的异常尿液检查标准和诊断所需的菌落计数阈值较低。需要进一步的研究来检查我们提出的指南的敏感性和特异性，所以它可能会取代目前多样化的指导方针。
方法：这是一项回顾性数据提取研究，包括2016年至2021年在儿科急诊科接受检查并进行尿培养的0-6个月大的患者。对于每个病人来说,我们把诊断记录在病历上,基于AAP和以色列指南的诊断，并根据我们提出的2个方案进行诊断。然后，我们根据每个诊断指南比较了UTI诊断的百分比。
结果：在研究期间，共有1432例6月龄以下的患者接受了尿培养检测。根据AAP指南，这些患者中共有83例（5.81％）被诊断为UTI，根据以色列指南，184名患者（12.8%）被诊断为UTI，102（7.1%）和109（7.6%）的患者被诊断为UTI根据我们的第一个和第二个建议的指南，分别。
结论：我们提出了一种新的诊断方法（指南II），适用于2个月以上的患者，与AAP指南相比，具有强制性的异常尿液检查标准和诊断所需的菌落计数阈值较低。需要进一步的研究来检查我们提出的指南的敏感性和特异性，所以它可能会取代目前多样化的指导方针。
