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.
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
José B López
JB
Sastre
Antonio Ramos
AR
Aparicio
Gil D Coto
GD
Cotallo
Belén Fernández
BF
Colomer
Manuel Crespo
MC
Hernández
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