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Controlled Clinical Trial
. 2021 Feb 17;47(1):35.
doi: 10.1186/s13052-021-00982-0.

Incidence of urinary tract infection in neonates with significant indirect Hyperbilirubinemia of unknown etiology: case-control study

Ahmed Mahrous Kamal Baz  1 , Osama Abd El-Fattah El-Agamy  2 , Ashraf Mohamed Ibrahim  3
Affiliations
Controlled Clinical Trial

Incidence of urinary tract infection in neonates with significant indirect Hyperbilirubinemia of unknown etiology: case-control study

Ahmed Mahrous Kamal Baz et al. Ital J Pediatr. .

Abstract

Background: Indirect 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 work: We aimed to determine the association between UTI and significant unexplained neonatal indirect hyperbilirubinemia.

Methods: This 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.

Results: UTI 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.

Conclusion: In neonates with unexplained indirect hyperbilirubinemia, UTI should be considered as a pathological cause.

Keywords: Hyperbilirubinemia; Incidence; Neonates; Urinary tract infection.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Bar chart comparing neonates in case group according to phototherapy type where Group a represents `newborns with indirect hyperbilirubinemia and UTI confirmed by urine culture and Group b represents newborns with indirect hyperbilirubinemia but don’t have UTI or have pyuria. Conventional phototherapy is using light irradiance of 25–30 microwatts per square centimeter per nanometer (microW/cm2/nm) in the 430–490 nm band. Intensive Phototherapy is using light irradiance more than 30 microW/cm2/nm detected by radiometer
Fig. 2
Fig. 2
Pie chart of US kidney and pelvis results of neonates with UTI confirmed by urine culture (PUV = posterior urethral valve)
See this image and copyright information in PMC

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