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Urinary tract infection in preterm infants: the protective role of breastfeeding

Itzhak Levy1, Jacklin Comarsca, Miriam Davidovits

  • 1Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. lavyguy@bezeqint.net

Pediatric Nephrology (Berlin, Germany)
|October 22, 2008
PubMed

Insights

Urinary tract infections (UTIs) in preterm infants are linked to gender and peripheral IV catheters. Breastfeeding appears to reduce UTI risk in this vulnerable population.

Area of Science:

  • Neonatalogy
  • Pediatric Infectious Diseases
  • Clinical Microbiology

Background:

  • Urinary tract infections (UTIs) present differently in preterm infants compared to older children.
  • Limited data exists on specific risk factors for UTIs in preterm infants.

Purpose of the Study:

  • To clinically and microbiologically characterize UTIs in premature infants.
  • To identify risk factors associated with UTI development in preterm infants.
  • To investigate the potential protective role of breastfeeding against UTIs in this population.

Main Methods:

  • A case-control study was conducted in a tertiary-care neonatal intensive care unit (NICU) from 1995 to 2003.
  • Preterm infants (<37 weeks' gestation) diagnosed with UTI were compared to gestational age- and birth weight-matched controls (2:1 ratio).
  • Demographic, clinical, laboratory, and imaging data were collected and analyzed using logistic regression.

Main Results:

  • Out of 6198 premature infants, 56 (0.9%) had UTIs. Klebsiella spp. was the primary causative organism.
  • Male gender (OR 2.96) and the presence of a peripheral intravenous catheter were significantly associated with increased UTI risk.
  • Breast milk consumption was associated with a reduced risk of UTI (OR 0.314).

Conclusions:

  • Male gender and peripheral IV catheter use are significant risk factors for UTI in preterm infants.
  • Breastfeeding demonstrates a protective effect against UTIs in premature infants.
  • Further research into UTI prevention strategies in neonates is warranted.

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