Urinary Tract Infections in a Neonatal Intensive Care Unit

Mark F. Weems; Daniel Wei; Rangasamy Ramanathan; Lorayne Barton; Linda Vachon; Smeeta Sardesai

doi:10.1055/s-0034-1395474

American Journal of Perinatology, Table of Contents

Am J Perinatol 2015; 32(07): 695-702
DOI: 10.1055/s-0034-1395474

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Urinary Tract Infections in a Neonatal Intensive Care Unit

Mark F. Weems

¹Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Regional One Health and Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee

,

Daniel Wei

²Division of Neonatal Medicine, Department of Pediatrics, Keck School of Medicine of USC, LAC + USC Medical Center, University of Southern California, Los Angeles, California

,

Rangasamy Ramanathan

²Division of Neonatal Medicine, Department of Pediatrics, Keck School of Medicine of USC, LAC + USC Medical Center, University of Southern California, Los Angeles, California

,

Lorayne Barton

²Division of Neonatal Medicine, Department of Pediatrics, Keck School of Medicine of USC, LAC + USC Medical Center, University of Southern California, Los Angeles, California

,

Linda Vachon

³Department of Radiology, Keck School of Medicine of USC, LAC + USC Medical Center, University of Southern California, Los Angeles, California

,

Smeeta Sardesai

²Division of Neonatal Medicine, Department of Pediatrics, Keck School of Medicine of USC, LAC + USC Medical Center, University of Southern California, Los Angeles, California

› Author Affiliations

Abstract

Objective Our aim was to describe laboratory findings and imaging results for neonatal patients diagnosed with urinary tract infection (UTI).

Study Design Medical records were reviewed for infants diagnosed with UTI in a single neonatal intensive care unit (NICU) over a 13-year period.

Results Of the 8,241 patients admitted to the NICU during the study period, 137 infants were diagnosed with UTI. Imaging was reviewed for 101 patients. Renal pelvis dilation was found in 34% of patients and vesicoureteral reflux was found in 21%. Renal pelvis dilation was not associated with reflux (OR: 0.53 [95% CI: 0.18–1.5]). The sensitivity of urinalysis to detect a positive culture was 76%, and the specificity was 41%. Tests of cure for bacterial infections were uniformly negative.

Conclusion Renal pelvis dilation was common but not associated with reflux among NICU patients diagnosed with UTI. Diagnostic criteria in this population are not well defined, and guidelines are needed for diagnosis and management of UTIs in NICU patients.

Keywords

ultrasound - voiding cystourethrogram - vesicoureteral reflux - neonate - infant - urinary tract infection

Full Text

References

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