Urinary tract infection in the newborn: clinical and radio imaging studies.
The objective of this study was to assess clinical characteristics and results of radio imaging studies and compare community-acquired urinary tract infection (UTI) with nosocomial UTI in 301 neonates with UTI consecutively admitted to 28 neonatal units in Spain over 3 years (community-acquired UTI, n = 250; nosocomial UTI, n = 51). UTI was diagnosed in the presence of symptoms of infection together with any colony growth for a single pathogen from urine obtained by suprapubic aspiration, or >or=10(4) CFU/ml for a single pathogen from urine obtained by urethral catheterization. Abnormal renal ultrasound was present in 37.1% of cases (34% in community-acquired UTI and 54.5% in nosocomial UTI, P < 0.01). The voiding cystourethrography (VCUG) showed vesicoureteral reflux (VUR) in 27% of cases (23.8% in community-acquired UTI and 48.6% in nosocomial UTI, P < 0.01). In patients with abnormal renal ultrasound and VUR, renal scan with dimercaptosuccinic acid (DMSA) performed early after UTI revealed cortical defects in 69.5% of cases. However, in patients with abnormal renal ultrasound and normal VCUG, DMSA also revealed cortical defects in 39% of cases. The absence of VUR in neonates with UTI and abnormal renal ultrasound does not exclude the presence of cortical defects suggestive of pyelonephritis.
Sastre
José B López
JB
Service of Neonatology, Department of Paediatrics, Hospital Universitario Central de Asturias, Celestino Villamil s/n, E-33006 Oviedo, Asturias, Spain. jose_lopez_sastre@hotmail.com
Aparicio
Antonio Ramos
AR
Cotallo
Gil D Coto
GD
Colomer
Belén Fernández
BF
Hernández
Manuel Crespo
MC
D001724:Birth Weight; D003428:Cross Infection / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011859:Radiography; D013030:Spain / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology