Epidemiology of urinary tract infection in neonatal intensive care unit: A single center study in Egypt

Abstract

Introduction: The aim of this study is to describe the epidemiology of urinary tract infection (UTI) in newborn infants admitted to neonatal intensive care unit (NICU) of Zagazig University. Patients and Methods: This study included 206 neonates admitted to the NICU in the period from 1/1/2010 to 1/6/2010. All neonates were subjected to detailed history taking, including prenatal history, natal history, and postnatal history, with stress on symptoms suggestive of UTI. We examined all neonates generally and locally, every case was subjected to urine analysis; suprapubic aspiration was done for all cases. The diagnosis of UTI was established by the presence of at least 5 leukocytes per high power field. Urine culture, CBC (complete blood count), blood culture, and ultrasound scanning were also done for certain cases. Results: We found 75 newborns with clinical findings suggesting UTI. We classified our neonates according to the presence of at least 5 leukocytes in urine per high power field into two groups: Group I (−ve cases) without UTI included 44 neonates (31 males and 13 females) and Group II (+ve cases) with UTI included 31 neonates (24 males and 7 females). There was no significant difference between Group I and Group II with regard to gender, age, weight, and consanguinity. The incidence of UTI in NICU was 15.05% (33/206), prevalence among suspected cases of UTI in NICU was 41.3% (33/75), and of the 39 neonates with sepsis 33 had UTI (79.5%). Of the positive cases, 77.4% were full-term neonates and 22.6% were preterm neonates. Of the 31 cases with positive urinary culture there were 18 cases (58.1%) showing Escherichia coli, and 13 cases (41.9%) were positive for Klebsiella. Conclusion: This study has highlighted the need for routine urine analysis and culture, especially in high-risk newborns and to monitor the prevalence of UTI early in life. Also routine ultrasonographic screening should be done in all newborns with UTI to save the newborns and prevent the risk of complications, which may end in renal scarring and renal failure.