Exploring the potential factors affecting the type of pathogens responsible for urinary tract infection in neonatal hyper bilirubinemia

Abstract

Background: Unexplained neonatal hyperbilirubinemia may be the newborns’ sole clinical presentation of urinary tract infection (UTI). Objective: We aimed to determine the potential factors affecting the type of pathogens responsible for UTI in neonatal hyperbilirubinemia. Methods: This cross-sectional study retrospectively evaluated newborns admitted to the neonatal ward of Bandar Abbas Children’s hospital, between 2016 and 2018. Newborns with hyperbilirubinemia and culture-confirmed UTIs were included in the study. The following data were extracted from patients’ medical records: demographics and anthropometrics, type of delivery, newborn’s feeding, clinical manifestations, urine sampling method, and laboratory test results, including total bilirubin and urine culture. Results: Of the 96 neonates with hyperbilirubinemia and positive urine culture in this study, 63 (65.6%) were male. Their mean age was 13.60 ± 6.00 days. Escherichia coli (E. coli) was the most common pathogen isolated from the urine cultures (33.3%), followed by Klebsiella (24%). Age, sex, gestational age, birth weight, type of delivery, newborn’s feeding, clinical manifestations, total bilirubin levels, and urine sampling method were not associated with the type of pathogens isolated from urine culture (P>0.05). Conclusions: Most urine cultures from newborns with hyperbilirubinemia were positive for E. coli. None of the potential factors evaluated in this study were correlated with the type of pathogens responsible for UTI in neonates with hyperbilirubinemia.