Abstract
BackgroundIndirect hyperbilirubinemia is frequently encountered during neonatal period. Although it has different causes, in some cases it can’t be explained. Previous studies have illustrated that jaundice could be a major sign of urinary tract infection (UTI) in neonates.Aim of the workWe aimed to determine the association between UTI and significant unexplained neonatal indirect hyperbilirubinemia.MethodsThis prospective controlled study was performed on 150 neonates divided in two groups (100 as cases and 50 as controls) to investigate the incidence of UTI in neonates with significant unexplained hyperbilirubinemia. Urine sample was obtained using urine catheterization technique from neonates and full urine analysis was done and cases with pyuria had urine culture to confirm UTI. Immediate renal ultrasonography (USG) was performed for neonates with UTI.ResultsUTI incidence was 11% in cases while none of neonates in control group had UTI with statistical significance between cases and controls (P value < 0.05). The most common (36.4%) pathogen was Escherichia coli. Posterior urethral valve with mild hydronephrosis was diagnosed in 18.2% of UTI positive patients by renal ultrasonography.ConclusionIn neonates with unexplained indirect hyperbilirubinemia, UTI should be considered as a pathological cause.
Highlights
Posterior urethral valve with mild hydronephrosis was diagnosed in 18.2% of urinary tract infection (UTI) positive patients by renal ultrasonography
In neonates with unexplained indirect hyperbilirubinemia, UTI should be considered as a pathological cause
This study indicated the incidence of UTI in our studied cases was 11% of jaundiced neonates while no case in control group diagnosed with UTI with significant statistical difference between 2 groups (P value < 0.05)
Summary
Total serum bilirubin doesn’t reach pathological levels while in others it may exceed physiological levels and requires treatment. Many well-known causes could be detected during routine investigation of Neonatal jaundice is mainly physiological and 60% of neonates have it. In neonates with Urinary Tract Infections (UTIs), jaundice could be an early sign [2]. One of the causes of prolonged jaundice is UTI. UTI investigations have been included in routine workup in. Indirect hyperbilirubinemia is frequently encountered during neonatal period. It has different causes, in some cases it can’t be explained. Previous studies have illustrated that jaundice could be a major sign of urinary tract infection (UTI) in neonates
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