Urinary Tract Infection in Infants <1 Month of Age: Demographic, Clinical, and Microbiological Characteristics

Abstract

Background: This cross-sectional study was conducted on 232 infants aged <1 month with proven UTI admitted to three major teaching hospitals for the period 2010-2018 to assess clinical, demographic, and laboratory findings of urinary tract infection in this age group.

Methods: All information was extracted from the medical records. Urinary tract infection was defined as ≥ 50,000 colony-forming units per milliliter of a single uropathogen isolated from a catheterized or suprapubic aspiration or greater than 100,000 colony-forming units per milliliter from a midstream, clean-catch sample.

Results: The most common pathogen isolated was E. coli (78.4%), followed by Enterobacter and Klebsiella, accounting for 12.1 and 4.7% respectively. The main presenting clinical manifestation was jaundice, which was found in 54.7% of cases; it was followed by restlessness (45.6%) and fever (40%).

Conclusion: During infancy, the signs and symptoms of UTI are often nonspecific and although urine culture is a gold standard diagnostic tool specimen collection is challenging and urine contamination is common in children, therefore it makes the diagnosis difficult. UTI in infants may indicate underlying genitourinary abnormalities; therefore, appropriate diagnosis and immediate initiation of antibiotic therapy are crucial to decrease long-term complications like renal scarring. According to our study, the most common clinical features were jaundice, restlessness, and fever, therefore it is suggested that urine culture should be performed for all infants presenting with these signs and symptoms.

Keywords: Escherichia coli; Urinary tract infection; fever; infant; jaundice; urine culture.