[Evaluation of urinary tract infections following Neonatal hyper-bilirubinemia]

ABSTRACT

Urinary tract infection [UTI] is a common and serious clinical problem in newborns. Previous studies have suggested that jaundice may be one of the signs of a UTI in infants. The aim of this study was to evaluate the incidence, age presentation, severity of jaundice, signs and complications of UTI in newborns with asymptomatic, unexplained indirect hyperbilirubinemia in the first month of life. This case-control study was conducted at the Neonatal intensive care unit, Ghaem Hospital, in Mashhad from May 2004 to April 2009. We evaluated asymptomatic, jaundiced infants for the evidence of having UTI. Some laboratory tests such as a serum fractionated bilirubin level, as well as urinanalysis and a urine culture were performed in all patients. Renal ultrasound was performed in almost all the cases with UTI. Detailed questionnaires, which were included demographic information, prenatal, intrapartum, postnatal events and risk factors were filled. The control group was jaundiced-infants with unknown etiology. A total of 1487 patients were enrolled in this study. From these patients 1061 infants were evaluated for UTI. There was a statistically significant difference [P<0.05] between the two groups regarding age presentation, age admitted to hospital, age improved jaundice, serum bilirubin level and hospital stay. UTI was diagnosed in seventy four [6.97%]. Renal ultrasound showed urinary tract abnormalities in thirty two [32%] patients. Six infants had unilateral grade 1-3 reflux in voiding cystourethrogram. In our study UTI was found in 7% of asymptomatic, jaundiced infants. Therefore, we recommend that a UTI test should be included in asymptomatic, jaundiced infants presenting after five day of life as part of their evaluation.These infants should be evaluated for urinary tract abnormalities by renal ultrasound and voiding cystourethrogram