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Urinary tract infection in the newborn: clinical and radio imaging studies

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Abstract

The objective of this study was to assess clinical characteristics and results of radio imaging studies and compare community-acquired urinary tract infection (UTI) with nosocomial UTI in 301 neonates with UTI consecutively admitted to 28 neonatal units in Spain over 3 years (community-acquired UTI, n = 250; nosocomial UTI, n = 51). UTI was diagnosed in the presence of symptoms of infection together with any colony growth for a single pathogen from urine obtained by suprapubic aspiration, or ≥104 CFU/ml for a single pathogen from urine obtained by urethral catheterization. Abnormal renal ultrasound was present in 37.1% of cases (34% in community-acquired UTI and 54.5% in nosocomial UTI, P < 0.01). The voiding cystourethrography (VCUG) showed vesicoureteral reflux (VUR) in 27% of cases (23.8% in community-acquired UTI and 48.6% in nosocomial UTI, P < 0.01). In patients with abnormal renal ultrasound and VUR, renal scan with dimercaptosuccinic acid (DMSA) performed early after UTI revealed cortical defects in 69.5% of cases. However, in patients with abnormal renal ultrasound and normal VCUG, DMSA also revealed cortical defects in 39% of cases. The absence of VUR in neonates with UTI and abnormal renal ultrasound does not exclude the presence of cortical defects suggestive of pyelonephritis.

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Acknowledgements

We thank Marta Pulido, MD, for editing the manuscript and editorial assistance.

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Authors and Affiliations

  1. Service of Neonatology, Department of Paediatrics, Hospital Universitario Central de Asturias, Celestino Villamil s/n, E-33006 Oviedo, Asturias, Spain

    José B. López Sastre, Antonio Ramos Aparicio, Gil D. Coto Cotallo, Belén Fernández Colomer & Manuel Crespo Hernández

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  1. José B. López Sastre
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  2. Antonio Ramos Aparicio
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  4. Belén Fernández Colomer
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Grupo de Hospitales Castrillo

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Correspondence to José B. López Sastre.

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Members of “Grupo de Hospitales Castrillo”: R. Reparaz Vidal, Hospital Juan Canalejo, A Coruña; I. Fidalgo Álvarez, Hospital del Bierzo, Ponferrada; E. Álvaro Iglesias, Complejo Hospitalario de León; M.P. Aragón García, Hospital Clínico and C. González Armengod, Hospital del Río Hortega, Valladolid; A. Urbón Artero, Hospital de la Seguridad Social, Segovia; P. Aparicio Lozano, Hospital General Yagüe, Burgos; A. Ibáñez Fernández, Hospital Universitario Central de Asturias, Oviedo; A. Cotero Lavín, Hospital de Cruces, Bilbao; L. Paisán Grisolía, Hospital de Donosita, San Sebastián; A. Marco Tello, Hospital Miguel Server and J. Pérez González, Hospital Clínico, Zaragoza; C. de Alba Romero, Hospital Doce de Octubre, M. Moro Serrano, Hospital Clínico San Carlos and J. Quero Jiménez, Hospital La Paz, Madrid; X. Carbonell Estrany and J. Figueras Aloy, Hospital Clínic and Casa Maternitat, X. Krauel Vidal and M. Iriondo Sanz, Hospital de Sant Joan de Déu and C. Céspedes Domínguez, Institut Universitari Dexeus, Barcelona; V. Roqués Serradilla, Hospital La Fe, Valencia; J. Ortiz Tardío, Hospital de la Seguridad Social, Jérez de la Frontera; M. García del Río, Hospital Materno Infantil-Clínico Universitario, Málaga; M. Samaniego Muñoz, Hospital Virgen de las Nieves and E. Narbona López, Hospital Clínico, Granada; M.L. Rosso González, Hospital Juan Ramón Jiménez, Huelva; A. Garcés, Hospital Punta Europa Algeciras; M.J. García García, Hospital San Pedro de Alcántara, Cáceres; and E. Doménech Martínez, Hospital Clínico Santa Cruz de Tenerife, Spain.

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López Sastre, J.B., Ramos Aparicio, A., Coto Cotallo, G.D. et al. Urinary tract infection in the newborn: clinical and radio imaging studies. Pediatr Nephrol 22, 1735–1741 (2007). https://doi.org/10.1007/s00467-007-0556-5

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  • DOI: https://doi.org/10.1007/s00467-007-0556-5

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