Abstract
Objective: Early diagnosis of urinary tract infection (UTI) in newborn infants will reduce the risk of infection-induced renal damage. Our aim in this study was to evaluate the newborns diagnosed with UTI and observed in our clinic and to review their clinical and laboratory findings.
Material and Methods: Infants diagnosed with UTI and observed as inpatients between January 2014 and January 2016 at the Neonatology Clinic of Dr. Behçet Uz Pediatrics and Pediatric Surgery Training and Research Hospital were evaluated with a detailed history, clinical and physical examinations, laboratory findings, clinical observations and radiologic outcomes.
Results: There were 35 infants diagnosed with UTI and the most common symptom was jaundice (45.7%, n=16). There were nitrites in 28.5% (n=10) and leucocytes in 68.5% (n=24) on urinalysis and both were present in 25.7% of the cases (n=9). A statistically significant relationship between nitrite positivity and leukocyte presence was found in patients with a positive urine culture (p=0.04). E. coli was the most frequent microorganism with a rate of 42.8% (n=15) in the urine cultures obtained through a urinary catheter or suprapubic aspiration.Extended-spectrum beta lactamase (ESBL) positivity (n=2) of E. coli became prominent if there was positivity in the control urine culture at the 48th hour of antibiotherapy. There were 6 cases (17.1%) diagnosed with hydronephrosis in the antenatal period, and 11 cases (31.4%) diagnosed with hydronephrosis by postnatal renal ultrasonography (US). However, only 4 cases (11.4%) had pathologic findings both with antenatal and postnatal US. A statistically significant relationship between antenatal and postnatal hydronephrosis was detected in patients with a positive culture (p<0.05).
Conclusion: In the neonatal period, UTI has nonspecific symptoms such as jaundice, irritability and vomiting. If there is a suspicion of UTI in a newborn, urinalysis and urine culture should be requested and the infection should not be overlooked. Families should be aware of the importance of antenatal follow-up by US and the postnatal follow-up of infants by the neonatology and pediatric nephrology departments before suffering a UTI
Keywords: Newborn, Urinary tract infection, Renal abnormality, Antenatal, Hydronephrosis
References
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