Urinary tract infection is common in VLBW infants

J Perinatol. 2019 Jan;39(1):80-85. doi: 10.1038/s41372-018-0226-4. Epub 2018 Sep 12.

Abstract

Objective: Determine the significance of urinary tract infection (UTI) as a cause of late onset sepsis (LOS) in very low birth weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU).

Study design: Analysis of blood, cerebrospinal fluid and urine culture results in VLBW infants >72-h old, admitted to the Georgetown University Hospital NICU between 2005 and 2015.

Result: Of 527 VLBW infants, 297 (56.4%) underwent 911 evaluations for LOS; only one-third included urine cultures. UTI was diagnosed in 8.5% of VLBW infants (range 2-15.9%) and in 13.8% of infants weighing < 1000 g at birth. Gram-negative infections predominated. Concomitant blood cultures were negative in 96% of infants. UTI was more common than bloodstream infection by 2015.

Conclusion: UTI is a significant cause of infection in VLBW infants. Urine culture should be included in all LOS evaluations in order to facilitate accurate diagnosis and appropriate antibiotic therapy.

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Early Diagnosis
  • Early Medical Intervention / methods
  • Early Medical Intervention / standards
  • Female
  • Gram-Negative Bacteria* / classification
  • Gram-Negative Bacteria* / isolation & purification
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight / urine
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Intensive Care, Neonatal* / methods
  • Intensive Care, Neonatal* / standards
  • Male
  • Neonatal Sepsis* / epidemiology
  • Neonatal Sepsis* / etiology
  • Neonatal Sepsis* / prevention & control
  • United States / epidemiology
  • Urinalysis / methods
  • Urinalysis / statistics & numerical data
  • Urinary Tract Infections* / diagnosis
  • Urinary Tract Infections* / epidemiology
  • Urinary Tract Infections* / microbiology
  • Urinary Tract Infections* / therapy

Substances

  • Anti-Bacterial Agents