Incidence of urinary tract infection in neonates with septicemia: a prospective study

The aim of this study was to investigate the incidence and clinical course of urinary tract infection (UTI) in neonates with septicemia and also determine the most common UTI manifestations in hospitalized neonates.

A cross-sectional study was carried out on consecutive febrile infants aged 1 to 56 days that were hospitalized in the neonatal intensive care unit. In all neonates with positive urine culture, scintigraphy with technetium-99m-labeled dimercaptosuccinic acid (DMSA) and ultrasonography (US) were performed. Voiding cystourethrography was performed in the course of the illness, generally within 5-7 days of hospitalization.

Positive blood culture was detected only in 9% of patients. However, 5% of them had positive urine culture. Positive abnormal US findings were present in two of five (40%) and vesicoureteral reflux (VUR) was present in one of five (20%) of infants with positive urine culture.

DMSA scan revealed renal parenchymal abnormalities in 3 of 5 (60%) neonates with urosepsis. The incidence of UTI in neonates with septicemia is low. All neonates with sepsis and positive urine culture should undergo a screening renal scintigraphy and cystogram for identifying renal parenchymal involvement and urinary tract abnormalities.