title: Urinary tract infections in infants: comparison between those with conjugated vs unconjugated hyperbilirubinaemia.
abstract: OBJECTIVE
  The aim was to investigate conjugated and unconjugated hyperbilirubinaemia in association with urinary tract infection (UTI) in young infants.
  
  
  METHODS
  Fifty infants aged <3 mths who developed prolonged jaundice among 2128 infants with UTI from 1984 to 2004 were enrolled retrospectively. They were divided into conjugated (n=22) and unconjugated (n=28) hyperbilirubinaemia groups and the clinical variables between the two were compared.
  
  
  RESULTS
  Compared with the unconjugated group, the conjugated hyperbilirubinaemia group had statistically significantly lower haemoglobin (1.57 vs 1.80 micromol/L), higher aspartate aminotransferase (96 vs 32.5 U/L) and alanine aminotransferase (81.5 vs 16 U/L), were older on admission (48.0 vs 32.5 days), had a longer duration of jaundice before treatment (43.5 vs 30 days) and a higher incidence of E. coli infections (19/22 vs 15/28). The direct/total bilirubin ratio was linearly correlated with duration of jaundice before treatment (p=0.004). The most significant cut-off value for the duration of jaundice vis-à-vis the type of jaundice was 38 days (p=0.007). Patients who on presentation had had jaundice for >44 days (p=0.007) were unlikely to have unconjugated hyperbilirubinaemia.
  
  
  CONCLUSIONS
  Infants with UTI may present with unconjugated hyperbilirubinaemia in the early stage. After 6 weeks, it is always conjugated hyperbilirubinaemia and is frequently associated with anaemia, elevated hepatic aminotransferases and E. coli infections.
authors.affiliation: Department of Paediatrics, Mackay Memorial Hospital, Taiwan; Department of Paediatrics, Taipei Medical Uinversity, Taiwan.
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Lee
authors.forename: Shiuh-Bin
authors.initials: SB
authors.lastname: Fang
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Yeung
authors.forename: Jeng-Daw
authors.initials: JD
authors.lastname: Tsai
mesh_terms: D001663:Bilirubin / Q000097:blood; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood / Q000150:complications* / Q000382:microbiology; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000150:complications / Q000382:microbiology; D007223:Infant; D007231:Infant, Newborn; D007565:Jaundice / Q000097:blood / Q000150:complications / Q000382:microbiology; D007567:Jaundice, Neonatal / Q000097:blood / Q000150:complications / Q000382:microbiology; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D000637:Transaminases / Q000097:blood; D014552:Urinary Tract Infections / Q000097:blood / Q000150:complications* / Q000382:microbiology
chemical_list: D000637:Transaminases; D001663:Bilirubin