Etiology of the urinary tract infections in infants

Abstract

Objective: To determine the incidence of pathogens causing uncomplicated and complicated urinary tract infections in term infants and to determine a possible predictive factors associated with the presence of the most common pathogens in urine samples. Methods: This retrospective study includes term newborns hospitalized at the University Children's Hospital for urinary tract infections during ten years. Data were collected from medical records available. Results: Total count of 4261 neonates hospitalized in the 10 years period, 286 (6.7%) were admitted to the ward because of an urinary tract infection. Complicated urinary tract infections were diagnosed in 61 ( 21.3% ) patients, but uncomplicated were diagnosed in 225 ( 78.7% ). As the leading cause of uncomplicated urinary tract infections among neonates E.coli was found aprox in 60.8 %, Klebsiella in 13.3 % and Enterococcus in 4.9%. Three of the most common pathogens isolated in urine samples in complicated infections were 52.5% Escherishia coli, Klebsiella 23.0% and Enterococcus 11.5%. The results have showed that higher the age of neonates at admission is associated with higher chances that the cause of Escherichia coli ( OR = 1.06 , 95% CI:1.02 - 1.11), while the female gender and complicated urinary tract infection are taken as protective factors (OR = 0.27 , 95% CI: 0.14 -0.49, and OR = 0.38 , 95% CI: 0.19 -0.74 ). On the other hand, female gender is taken as a risk factor for the development of urinary tract infections caused by Klebsiella bacteria ( OR = 2.75, 95% CI:1.44 -5.26) and Enterococcus ( OR = 3.05 , 95% CI: 1.33 - 6.97 ). Additional risk factor for urinary tract infection of infants caused by Enterococcus is complexity of infection (OR=2.61, 95% CI: 1.10-6.20). Conclusion: The data obtained in the study may be useful in making the choice of which antibiotics can be used in the early stages of treatment of urinary infection in term neonates. It is preferred to conduct further research on the resistance profiles of the leading causes of infant urinary tract infections to antibiotics.