Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance

Background: It is controversial to test for urinary tract infection (UTI) in patients with unexplained indirect hyperbilirubinemia in the first 2 weeks of life. We aimed to study the prevalence and significance of UTIs in such neonates who were requiring phototherapy. Methods: Subjects were 2- to 14...

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Main Authors: Elif Bahat Ozdogan, Mehmet Mutlu, Secil Arslansoyu Camlar, Gülcin Bayramoglu, Sebnem Kader, Yakup Aslan
Format: Article
Language:English
Published: Elsevier 2018-06-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957217300566
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author Elif Bahat Ozdogan
Mehmet Mutlu
Secil Arslansoyu Camlar
Gülcin Bayramoglu
Sebnem Kader
Yakup Aslan
author_facet Elif Bahat Ozdogan
Mehmet Mutlu
Secil Arslansoyu Camlar
Gülcin Bayramoglu
Sebnem Kader
Yakup Aslan
author_sort Elif Bahat Ozdogan
collection DOAJ
description Background: It is controversial to test for urinary tract infection (UTI) in patients with unexplained indirect hyperbilirubinemia in the first 2 weeks of life. We aimed to study the prevalence and significance of UTIs in such neonates who were requiring phototherapy. Methods: Subjects were 2- to 14-day-old neonates with indirect bilirubin levels above phototherapy limit with no other abnormality in their bilirubinaemia-related etiologic workup. UTI was diagnosed by 2 consecutive positive cultures obtained by catheterisation, documenting growth of >10,000 colonies of the same microorganism with consistent antibiograms. The UTI (+) patients were evaluated by renal ultrasonography (US), and some were followed up for possible recurrent UTI. Results: 262 neonates were included in the study. UTI prevalence was 12.2%, and bacteraemia was 6.2% among UTI (+) patients. The two most common pathogens (81.2%) were Escherichia coli and Klebsiella. pneumonia. All UTI (+) patients had undergone US, revealing 12.5% pelvicaliectasis, other 12.5% increased renal parenchymal echogenicity, 3.1% concurrent pelvicaliectasis and increased renal parenchymal echogenicity. 53.1% of UTI (+) patients had undergone follow-up, after which 23.5% recurrent UTI were found at the end of a mean of 52 months. Conclusion: We suggest that the neonates with unexplained pathological jaundice should be tested for possible UTI. Consequently, all newborns with UTI shall be evaluated by the urinary US and followed up for recurrent UTI.
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spelling doaj-art-0b43ee468b9549cdb4dfecafc2920cc82025-08-20T03:17:13ZengElsevierPediatrics and Neonatology1875-95722018-06-0159330530910.1016/j.pedneo.2017.10.010Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significanceElif Bahat Ozdogan0Mehmet Mutlu1Secil Arslansoyu Camlar2Gülcin Bayramoglu3Sebnem Kader4Yakup Aslan5Department of Pediatrics, Division of Pediatric Nephrology, Karadeniz Technical University, Faculty of Medicine, Trabzon, TurkeyDepartment of Pediatrics, Division of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, TurkeyDepartment of Pediatrics, Division of Pediatric Nephrology, Karadeniz Technical University, Faculty of Medicine, Trabzon, TurkeyDepartment of Microbiology, Karadeniz Technical University, Faculty of Medicine, Trabzon, TurkeyDepartment of Pediatrics, Division of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, TurkeyDepartment of Pediatrics, Division of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, TurkeyBackground: It is controversial to test for urinary tract infection (UTI) in patients with unexplained indirect hyperbilirubinemia in the first 2 weeks of life. We aimed to study the prevalence and significance of UTIs in such neonates who were requiring phototherapy. Methods: Subjects were 2- to 14-day-old neonates with indirect bilirubin levels above phototherapy limit with no other abnormality in their bilirubinaemia-related etiologic workup. UTI was diagnosed by 2 consecutive positive cultures obtained by catheterisation, documenting growth of >10,000 colonies of the same microorganism with consistent antibiograms. The UTI (+) patients were evaluated by renal ultrasonography (US), and some were followed up for possible recurrent UTI. Results: 262 neonates were included in the study. UTI prevalence was 12.2%, and bacteraemia was 6.2% among UTI (+) patients. The two most common pathogens (81.2%) were Escherichia coli and Klebsiella. pneumonia. All UTI (+) patients had undergone US, revealing 12.5% pelvicaliectasis, other 12.5% increased renal parenchymal echogenicity, 3.1% concurrent pelvicaliectasis and increased renal parenchymal echogenicity. 53.1% of UTI (+) patients had undergone follow-up, after which 23.5% recurrent UTI were found at the end of a mean of 52 months. Conclusion: We suggest that the neonates with unexplained pathological jaundice should be tested for possible UTI. Consequently, all newborns with UTI shall be evaluated by the urinary US and followed up for recurrent UTI.http://www.sciencedirect.com/science/article/pii/S1875957217300566follow-uphyperbilirubinemianeonateurinary tract infectionprevalence
spellingShingle Elif Bahat Ozdogan
Mehmet Mutlu
Secil Arslansoyu Camlar
Gülcin Bayramoglu
Sebnem Kader
Yakup Aslan
Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance
Pediatrics and Neonatology
follow-up
hyperbilirubinemia
neonate
urinary tract infection
prevalence
title Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance
title_full Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance
title_fullStr Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance
title_full_unstemmed Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance
title_short Urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia: Prevalence and significance
title_sort urinary tract infections in neonates with unexplained pathological indirect hyperbilirubinemia prevalence and significance
topic follow-up
hyperbilirubinemia
neonate
urinary tract infection
prevalence
url http://www.sciencedirect.com/science/article/pii/S1875957217300566
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