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Asymptomatic bacteriuria in healthy preterm babies

M Moncrieff, M Bamford, J Benson

Archives of Disease in Childhood

|September 1, 1980

Summary

Screening healthy preterm babies for urinary tract infections is not recommended. Studies show a very low incidence of bacteriuria, even with advanced urine collection methods.

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Area of Science:

Neonatal Medicine
Pediatric Infectious Diseases
Clinical Microbiology

Background:

Urinary tract infections (UTIs) can be serious in infants.
Accurate diagnosis of bacteriuria in preterm infants is challenging due to difficulties in obtaining uncontaminated urine samples.
Current diagnostic criteria for bacteriuria may be unreliable with non-invasive collection methods.

Purpose of the Study:

To investigate the incidence of bacteriuria in healthy preterm infants.
To evaluate the reliability of urine bag specimens versus suprapubic aspiration for diagnosing UTIs in this population.

Main Methods:

Urine cultures were performed on 51 healthy preterm infants.
Initial urine samples were collected using sterile bags.
Repeat bag cultures or suprapubic aspiration (SPA) were used for confirmation if initial cultures showed significant bacterial growth (>50,000 organisms/ml).

Main Results:

90% of infants with potential bacteriuria (based on bag specimens) were excluded after one or two negative bag cultures.
Suprapubic aspiration urine samples were sterile in an additional 11 infants.
The incidence of proved bacteriuria, diagnosed via SPA, was zero in this cohort. A potential incidence of 1.3% was noted if two specific cases with pure growth were included.

Conclusions:

Diagnosing bacteriuria in preterm infants requires suprapubic urine samples for accuracy.
The incidence of proved UTIs in healthy preterm infants is very low.
Routine screening for bacteriuria in healthy preterm infants is not recommended due to diagnostic challenges and low prevalence.

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