Urinary tract infection in the neonatal intensive care unit

To determine adherence and safety of a diagnostic (culture, urinalysis) and therapeutic (5-day antibiotic course with a time-out) guideline for urinary tract infection (UTI) in the Neonatal Intensive Care Unit STUDY DESIGN: Prospective surveillance of non-bacteremic UTIs from 11/2020-12/2022. Safety outcomes were defined by re-initiation of antibiotics within 7 days for a subsequent UTI due to the same organism and overall and UTI-related mortality.

77 infants received treatment for 93 UTIs with 77% (72/93) adherence to diagnostic criteria; 90% (82/91) of infants received ≤6 days of definitive treatment (median [IQR] antibiotic duration 5 [5-6] days). Antibiotics were restarted within 7 days for a recurrent (same organism) UTI in 1/91 (1%) UTIs. Mortality was 4% (4/93); none were due to UTI.

Adherence to diagnostic UTI criteria was 77%. 90% of infants received short course treatment that was associated with a 1% failure rate. No safety concern was identified.