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. 2017 Jan;56(1):65-70.
doi: 10.1177/0009922816638664. Epub 2016 Jul 19.

Incidence of Breakthrough Urinary Tract Infection in Hospitalized Infants Receiving Antibiotic Prophylaxis

Jessica C Lloyd  1 , Christoph P Hornik  1 , Daniel K Benjamin  2 , Reese H Clark  3 , Jonathan C Routh  1 , P Brian Smith  1
Affiliations

Incidence of Breakthrough Urinary Tract Infection in Hospitalized Infants Receiving Antibiotic Prophylaxis

Jessica C Lloyd et al. Clin Pediatr (Phila). 2017 Jan.

Abstract

Urinary tract infections (UTIs) are a source of substantial morbidity in children in the neonatal intensive care unit. The incidence of UTIs that occur in critically ill infants during a course of antibiotic prophylaxis (i.e., breakthrough urinary tract infections [BUTIs]) is not known. We investigated the incidence of BUTI in a cohort of infants hospitalized on prophylactic antibiotics in neonatal intensive care units. Predictors of BUTI were evaluated using multivariable Cox regression. Out of 716 787 infants, 631 (0.09%) were prescribed 821 courses of antibiotic prophylaxis. Among this cohort, 60 infants (9.5%) suffered a total of 65 BUTIs. Of all prophylactic antibiotic courses, 65/821 (7.9%) were complicated by BUTI. Klebsiella, Enterobacter, and Escherichia coli species were the most common causes of BUTI. There was no statistically significant difference ( P = .78) in BUTI incidence among the 4 antibiotics assessed (amoxicillin, cephalexin, nitrofurantoin, or trimethoprim-sulfamethoxazole).

Keywords: antibiotics; antimicrobial prophylaxis; breakthrough urinary tract infection; infants; neonatal intensive care units.

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Conflict of interest statement

Declaration of Conflicting Interests

The remaining authors have no conflicts to disclose.

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