Mark F Weems1, Daniel Wei2, Rangasamy Ramanathan2, Lorayne Barton2, Linda Vachon3, Smeeta Sardesai2. 1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Regional One Health and Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee. 2. Division of Neonatal Medicine, Department of Pediatrics, Keck School of Medicine of USC, LAC + USC Medical Center, University of Southern California, Los Angeles, California. 3. Department of Radiology, Keck School of Medicine of USC, LAC + USC Medical Center, University of Southern California, Los Angeles, California.
Abstract
OBJECTIVE: Our aim was to describe laboratory findings and imaging results for neonatal patients diagnosed with urinary tract infection (UTI). STUDY DESIGN: Medical records were reviewed for infants diagnosed with UTI in a single neonatal intensive care unit (NICU) over a 13-year period. RESULTS: Of the 8,241 patients admitted to the NICU during the study period, 137 infants were diagnosed with UTI. Imaging was reviewed for 101 patients. Renal pelvis dilation was found in 34% of patients and vesicoureteral reflux was found in 21%. Renal pelvis dilation was not associated with reflux (OR: 0.53 [95% CI: 0.18-1.5]). The sensitivity of urinalysis to detect a positive culture was 76%, and the specificity was 41%. Tests of cure for bacterial infections were uniformly negative. CONCLUSION: Renal pelvis dilation was common but not associated with reflux among NICU patients diagnosed with UTI. Diagnostic criteria in this population are not well defined, and guidelines are needed for diagnosis and management of UTIs in NICU patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: Our aim was to describe laboratory findings and imaging results for neonatal patients diagnosed with urinary tract infection (UTI). STUDY DESIGN: Medical records were reviewed for infants diagnosed with UTI in a single neonatal intensive care unit (NICU) over a 13-year period. RESULTS: Of the 8,241 patients admitted to the NICU during the study period, 137 infants were diagnosed with UTI. Imaging was reviewed for 101 patients. Renal pelvis dilation was found in 34% of patients and vesicoureteral reflux was found in 21%. Renal pelvis dilation was not associated with reflux (OR: 0.53 [95% CI: 0.18-1.5]). The sensitivity of urinalysis to detect a positive culture was 76%, and the specificity was 41%. Tests of cure for bacterial infections were uniformly negative. CONCLUSION:Renal pelvis dilation was common but not associated with reflux among NICU patients diagnosed with UTI. Diagnostic criteria in this population are not well defined, and guidelines are needed for diagnosis and management of UTIs in NICU patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Dustin D Flannery; Erik Brandsma; Judy Saslow; Amy B Mackley; David A Paul; Zubair H Aghai Journal: J Matern Fetal Neonatal Med Date: 2017-12-20