Evaluation of the newborns with urinary tract infection İdrar yolu enfeksiyonlu yenidoğan bebeklerin değerlendirilmesi


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Üstündağ S., Özdemir Ö. M., Ergin H., YÜKSEL S.

Pamukkale Medical Journal, vol.15, no.4, pp.674-681, 2022 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 15 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.31362/patd.1082718
  • Journal Name: Pamukkale Medical Journal
  • Journal Indexes: Scopus, Central & Eastern European Academic Source (CEEAS), TR DİZİN (ULAKBİM)
  • Page Numbers: pp.674-681
  • Keywords: imaging, Newborn, urinary tract infection
  • Çanakkale Onsekiz Mart University Affiliated: No

Abstract

Purpose: Retrospective evaluation of infants followed up with the diagnosis of urinary tract infection (UTI) in the neonatal unit. Materials and methods: The clinical, laboratory findings and prenatal-postnatal imaging of 50 newborns followed up between 2015 and 2019 in our neonatal unit with the diagnosis of UTI (>10.000 cfu/ml microorganism growth in urine-culture taken via catheter) were evaluated. Results: Of 50 cases included in the study, 23 were female and 27 were male. Mean gestational-age was 34.3±4.6 weeks (minimum-maximum:23-41). Most cases (n=42, 84%) were normal weight for gestational-age. Twenty (40%) cases were asymptomatic, while thirty (60%) were symptomatic. Fever was more common in term infants; apnea was more common in preterms. E.coli (48%, n=24) and klebsiella pneumoniae (26%, n=13) growth were frequently detected in urine cultures. 12 (24%) of blood cultures taken simultaneously were positive (16% for coagulase-negative-staphylococci, n=8). When all cases were evaluated with postnatal urinary- system ultrasonography (USG); 68% (n=34) were normal, 32% (n=16) were detected as abnormal (n=5, 31.2% hydronephrosis; n=10, 68.8% nephrolithiasis, pelvicalyceal ectasia). Vesicoureteral-reflux (VUR) was detected in half of 12 cases (n=6, 50%) had abnormal ultrasound findings and underwent voiding-cystourethrography. Conclusion: While 40% of infants found to have UTI in the neonatal unit were asymptomatic, 60% were symptomatic, and E.coli growth was often observed in urine-culture. Postnatal urinary-system USG revealed abnormal findings in approximately 1/3 of these cases, hydronephrosis in 31.2% of them, and advanced VUR in all of hydronephrosis. In conclusion, newborns with UTI should be evaluated with ultrasound in terms of urinary-system malformation that may accompany, and those with hydronephrosis should be investigated for vesicoureteral-reflux.