Urinary-tract infections in African neonates

During a 4-year period between January 1987 and December 1990, 41 high-risk neonates with proven urinary tract infections (UTIs) were studied prospectively and compared with 55 control neonates. An incidence of 2.6 UTIs per 1000 live births was noted, amongst whom no obvious radiological abnormalities of the urinary tract were found. Significantly, more males than females developed UTIs, the ratio being 4.5:I. Low-birth-weight babies were significantly more often affected than those of normal weight (P less than 0.05). Staphylococcus aureus and Klebsiella spp. were the predominant pathogens isolated. Aetiologically, bacteraemia from sepsis was important. Most of the infants presented with a significantly higher incidence of pyrexia, abdominal distension, lethargy and jaundice (P less than 0.01). The overall mortality rate of 17.1% was closely related to these associated problems. The relatively high incidence of UTI and the rarity of radiological abnormalities of the urinary tract in the African neonate contrast with previous reports in the literature and the reason is worthy of consideration. Despite the rarity of urinary-tract anomalies, a continuous surveillance of the trend of neonatal UTI and its outcome is recommended.