English

Abstract

OBJECTIVE: Urinary Tract Infection (UTI) is an important clinical problem in the neonatal period. Early diagnosis and treatment of UTI is important. This study was undertaken to estimate the proportion of UTI in neonatal sepsis. METHODS: This prospective study included 207 neonates admitted with suspected sepsis. A detailed history and clinical examination was performed. Neonates presenting within 72 hours of life were grouped as early onset sepsis and after 72 hours of life were grouped as late onset sepsis. All the neonates were investigated for sepsis. Urine sample was collected by suprapubic aspiration and subjected to analysis and culture. Pyuria was defined by the presence of at least 5 leukocytes per high power field in a centrifuged sample and a positive urine culture- Bacterial growth of >1000 colony-forming units/ml was defined as UTI. RESULTS: Among the early onset sepsis group, 10.8% neonates had pyuria, of which 21.4% were culture positive. Among the late onset sepsis group, 44.2% neonates had pyuria, of which 35.3% were culture positive. Pyuria was more common in males (27.5%) than females (17.2%). Overall, culture positive UTI in EOS group was 2.3% and LOS group was 15.6% (p=0.001). Overall, the proportion of culture positive UTI in the entire study group was 7.2%. The most common causative organisms were E.Coli -53% followed by klebsiella- 27%. CONCLUSION: It is very important to investigate for the UTI in newborns with sepsis especially late onset sepsis, as it can be easily missed. As congenital malformations of the urinary tract are also associated with UTI, it is essential to investigate for the same. Undiagnosed and/or inadequately treated UTI can lead to renal scarring, hypertension and end stage renal disease. This study highlights the need for routine urine analysis and culture, especially in newborns with late onset sepsis so they can be treated appropriately.