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Neonatal urinary tract infections: analysis of the patients and recurrences
Nese Karaaslan Biyikli1, Harika Alpay, Eren Ozek
1Departments of Pediatric Nephrology and Neonatology, Marmara University School of Medicine, Istanbul, Turkey. nesebiyikli@superonline.com
Insights
Neonatal urinary tract infections (UTIs) require prompt diagnosis and treatment. Long-term follow-up is crucial for identifying complications and preventing recurrent infections in infants.
Area of Science:
- Pediatric Nephrology
- Neonatal Medicine
- Infectious Diseases
Background:
- Neonatal urinary tract infections (UTIs) necessitate early detection and comprehensive management.
- Long-term monitoring is essential for optimal outcomes in affected infants.
Purpose of the Study:
- To analyze the clinical characteristics and long-term outcomes of 71 neonates treated for UTI.
- To identify risk factors and patterns of recurrence in neonatal UTIs.
Main Methods:
- Retrospective analysis of 71 newborns diagnosed with UTI.
- Evaluation of clinical presentation, causative agents, diagnostic findings, and follow-up data.
Main Results:
- 41% of patients were preterm; sepsis and hyperbilirubinemia were common presentations.
- Escherichia coli and Klebsiella pneumoniae were leading pathogens for community-acquired and nosocomial UTIs, respectively.
- Recurrence rate was 28%, predominantly within the first six months, often without identifiable predisposing abnormalities.
Conclusions:
- Pediatric nephrologic follow-up is vital for detecting congenital anomalies and renal scarring in infants with neonatal UTIs.
- Early diagnosis and management of recurrent UTIs are critical for preventing long-term renal damage.
Background:
Early diagnosis and proper treatment, including long-term follow up, are very important for neonatal urinary tract infections (UTI).
Methods:
The present study reports the analysis and long-term follow-up results of 71 newborns treated for UTI.
Results:
Forty-one per cent of patients were preterm babies. Suspected sepsis and hyperbilirubinemia were the main presenting features. Community-acquired and nasocomial UTI accounted for 63% and 37% of cases, respectively. The leading causative agents were Escherichia coli for community-acquired UTI and Klebsiella pneumoniae for nasocomial UTI. The urosepsis rate was 5%. Abnormal ultrasonography findings were present in 23% and vesicoureteral reflux was present in 15% of babies. A total of 23% of patients showed renal photopenic areas on dimercaptosuccinic acid scan. The recurrence rate was 28% occurring between 1.5 and 12 months, in particular in the first 6 months. Most of the recurrences developed in patients with no predisposing abnormalities.
Conclusion:
Pediatric nephrologic follow-up of babies experiencing UTI in the neonatal period is very important to identify the predisposing congenital abnormalities and scarred kidneys, to diagnose and to treat the recurrences earlier.
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