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One in six febrile neonates affected by UTI
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About one in six febrile infants younger than 30 days are affected by a urinary tract infection, according to recent study findings published in The Pediatric Infectious Disease Journal.
The study included 651 febrile infants presenting to an ED between 2004 and 2013. Before evaluation in the ED, no patient received antibiotics. A urine culture was obtained from all patients.
William Bonadio, MD, of Maimonides Medical Center in Brooklyn, N.Y., found the following bacterial pathogens present in 100 patients diagnosed with UTI: Escherichia coli (n=71); Enterococcus (10); Klebsiella pneumoniae (7); K. oxytoca (3); Enterobacter cloacae (3); group B streptococcus(1); Pseudomonas aeruginosa (1); Staphylococcus aureus (1); coagulase-negative staphylococci (1); Serratia marcescens (1); and viridans streptococci (1).
Anatomic abnormalities were found in 45 of 95 patients who received a renal ultrasound, and five of 26 patients with hydronephrosis had viscoureteral reflux on voiding cystourethrogram. No patients died during the study period or had bacterial meningitis, but four with UTI had urosepsis.
“All febrile young infants should receive performance of a urine culture; those with UTI require [renal ultrasonography] imaging,” Bonadio wrote. “Those with hydronephrosis should have further evaluation for [vesicoureteral reflux]. The purpose of renal imaging is to detect urologic abnormalities that require additional management, such as further radiographic studies or subspecialty consultation. Identifying abnormalities is important to determine prognosis, and establish appropriate follow-up and monitoring so as to maximize renal function.”
Disclosure: Bonadio reports no relevant financial disclosures.
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