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Published on: October 12, 2017
Risk factors for urinary tract infection in infants with unexplained hyperbilirubinemia: a single center case-control
Ing Chen1, Li-Sang Hsu1, Cai-Sin Yao2,3
1Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Insights
Urinary tract infection (UTI) is common in jaundiced infants. Screening for UTI is recommended, especially in males or those with high bilirubin levels, to guide treatment.
Area of Science:
- Neonatology
- Pediatric Infectious Diseases
- Clinical Diagnostics
Background:
- Urinary tract infection (UTI) is a recognized cause of neonatal jaundice.
- Current practices for screening UTI in infants with hyperbilirubinemia lack consensus.
- This study investigates UTI prevalence and risk factors in jaundiced infants.
Purpose of the Study:
- To determine the prevalence of UTI in jaundiced infants.
- To identify risk factors associated with UTI in this population.
- To assess the impact of UTI on neonatal jaundice severity and duration.
Main Methods:
- A retrospective case-control study of 150 jaundiced infants (< 8 weeks) with unknown hyperbilirubinemia etiology.
- All infants received phototherapy and underwent UTI screening via catheterization.
- Infants were grouped into UTI and non-UTI based on urine culture results (≥10,000 CFU/mL).
Main Results:
- UTI prevalence was 29% among jaundiced infants.
- Male gender and peak total bilirubin > 18 mg/dL were significant risk factors for UTI.
- UTI was associated with a longer hospitalization duration; common pathogens were E. coli and E. faecalis.
Conclusions:
- UTI screening is crucial for jaundiced infants with unclear etiology.
- Consider UTI screening in infants with identified risk factors or poor response to phototherapy.
- Early detection and treatment of UTI can impact jaundice management.
Background:
Urinary tract infection (UTI) is a potential cause of neonatal jaundice. Nevertheless, there remains a lack of consensus regarding appropriate screening practices for UTI in infants with hyperbilirubinemia. This study aimed to analyze a group of jaundiced infants to assess the prevalence of UTI, explore potential risk factors, and examine the impact of UTI on the course and severity of neonatal jaundice.
Methods:
This retrospective case-control study was conducted on 150 jaundiced infants (aged < 8 weeks) without a known etiology in the hyperbilirubinemia work-up. All subjects underwent phototherapy treatment and UTI screening by catheterization. They were then classified into UTI and non-UTI groups based on urine culture results, with a positive urine culture indicating the growth of ≥10,000 colony-forming units. The clinical characteristics and jaundice-related parameters of both groups were analyzed.
Results:
Among the 150 jaundiced patients, the prevalence of UTI was 29%. There was a significantly higher male predominance in the UTI group, and patients with UTI also had a significantly longer duration of hospitalization compared to those without UTI. Significant risk factors associated with UTI in jaundiced infants included male gender and a peak total bilirubin level higher than 18 mg/dl during hospitalization. The most common pathogens identified in urine culture were Escherichia coli (41.9%) and Enterococcus faecalis (30.2%).
Conclusion:
In cases of neonatal jaundice where the underlying cause is not evident, screening for UTI should be performed, particularly when associated risk factors or inadequate response to phototherapy is present.
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