Urinary tract infections in infants: comparison between those with conjugated vs unconjugated hyperbilirubinaemia.
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.
Lee
Hung-Chang
HC
Department of Paediatrics, Mackay Memorial Hospital, Taiwan; Department of Paediatrics, Taipei Medical Uinversity, Taiwan.
Fang
Shiuh-Bin
SB
Yeung
Chun-Yan
CY
Tsai
Jeng-Daw
JD
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
D000637:Transaminases; D001663:Bilirubin