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Is screening for urine infection in well infants with prolonged jaundice required? Local review and meta-analysis of

S Steadman1, I Ahmed2, K McGarry3

  • 1Neonatal Unit, New Cross Hospital, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.

Archives of Disease in Childhood
|February 27, 2016
PubMed

Insights

Routine urine cultures for prolonged infant jaundice are not supported by UK data. The incidence of urinary tract infections (UTIs) in these infants is very low, questioning current national guidance.

Area of Science:

  • Neonatal Medicine
  • Pediatric Infectious Diseases
  • Clinical Guidelines

Background:

  • National Institute for Health and Care Excellence (NICE) guidance recommends urine cultures for prolonged neonatal jaundice.
  • The evidence base for this recommendation is limited.
  • This study aimed to evaluate the necessity of routine urine cultures in such cases.

Purpose of the Study:

  • To review local data and existing literature on urine tract infection (UTI) rates in infants with prolonged jaundice.
  • To determine if current NICE guidance for investigating prolonged jaundice is evidence-based.
  • To inform potential revisions to national guidelines.

Main Methods:

  • Retrospective review of urine cultures from an outpatient prolonged jaundice clinic over three years.
  • Systematic literature review and meta-analysis of studies reporting UTI rates in jaundiced infants.
  • Pooled analysis of local and global data.

Main Results:

  • No significant UTIs were found in 279 local patients meeting criteria for prolonged jaundice.
  • Global UTI rates in prolonged jaundiced infants varied significantly.
  • Pooled UK data showed a UTI incidence of 0.21% (95% CI 0.0% to 0.73%) in prolonged jaundiced infants, substantially lower than international figures (8.21%).

Conclusions:

  • Current evidence, including local data and literature, does not support routine urine culture screening for well infants with prolonged jaundice.
  • The study unit has ceased routine urine culture screening for these infants.
  • There is a need for NICE to re-evaluate its guidance on UTI screening in prolonged neonatal jaundice.
Abstract

Keywords:
Evidence Based MedicineGeneral PaediatricsJaundiceNeonatologyScreening

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