Abstract
BackgroundUrinary tract infection (UTI) is the most common and life-threatening bacterial infection among neonates. This study aimed to determine the prevalence, aetiology, and susceptible antimicrobial agents among neonates with UTI.MethodsThis was a cross-sectional analytical hospital-based study that included 152 neonates with clinical sepsis who were admitted at Dodoma regional referral hospital from January to June 2020. Bacterial growth of 1 × 103 colony forming units/mL of a single uropathogen was used to define the presence of UTI. Statistical analysis was performed using SPSS version 23.0 and multivariate analysis was used to determine the predicting factors of UTI. P <0.05 was regarded statistically significant.ResultsThe prevalence of UTI was 18.4% (28/152). Klebsiella pneumoniae 64.3% (18/28) and Enterobacter spp. 35.7% (10/28) were the bacterial agents isolated. The bacterial isolates were 90%, and 60% sensitive to ciprofloxacin and amikacin, respectively. Low Apgar score (AOR = 12.76, 95% CI = 4.17–39.06, p<0.001), prolonged labour (AOR = 5.36, 95% CI = 1.28–22.52, p = 0.022), positive urine nitrite test (AOR = 26.67, 95% CI = 7.75–91.70, p<0.001), and positive leucocyte esterase test (AOR = 6.64, 95% CI = 1.47–29.97, p = 0.014) were potential predictors of UTI.ConclusionThe prevalence of UTI confirmed by urine culture among neonates that were included in the present study indicates that this problem is common in the population where the study was conducted. Klebsiella pneumoniae and Enterobacter spp. were the uropathogens which were isolated. Ciprofloxacin, nitrofurantoin, and amikacin were sensitive to the isolated uropathogens.
Highlights
Urinary tract infection (UTI) is the most common and life-threatening bacterial infection among neonates
The paediatric department has two specialized clinics, one of which is a care and treatment clinic (CTC) for paediatric patients who are diagnosed with human immunodeficiency virus (HIV) and the other one is a general paediatric clinic which operates on regular basis
Of all the paediatric patients, 31.5% (448/1422) of them were neonates. These neonates were screened based on signs and symptoms of clinical sepsis and at the end, 49.3% (148/300) neonates were excluded due to various reasons including having had received antibiotics within 48 h and refusal of the parents to sign the consent forms
Summary
Urinary tract infection (UTI) is the most common and life-threatening bacterial infection among neonates. Urinary tract infection (UTI) is among the primary causes of neonatal sepsis its rate in newborns is not known. The prevalence of UTI in neonates with clinical and blood culture-confirmed neonatal sepsis ranges from 7 to 41.3% [5,6,7,8,9]. In Tanzania, the prevalence of UTI among neonates was previously reported to be 11.4% in a study which was conducted in Kilimanjaro [10]. The prevalence of UTI among febrile infants in the USA has been reported to range from 10.7 to 15.4% [12]. Mohamed et al reported a prevalence of 6.7% of UTI among neonates in a study which was conducted in Egypt [13]
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