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. 2024 Jan 25:12:1332052.
doi: 10.3389/fped.2024.1332052. eCollection 2024.

Risk factors for urinary tract infection in infants with unexplained hyperbilirubinemia: a single center case-control study

Ing Chen  1 , Li-Sang Hsu  1 , Cai-Sin Yao  2   3 , Jenn-Tzong Chang  1 , Hsiao-Ping Wang  1 , Nai-Wen Fang  4   5
Affiliations

Risk factors for urinary tract infection in infants with unexplained hyperbilirubinemia: a single center case-control study

Ing Chen et al. Front Pediatr. .

Abstract

Background: Urinary tract infection (UTI) is a potential cause of neonatal jaundice. Nevertheless, there remains a lack of consensus regarding appropriate screening practices for UTI in infants with hyperbilirubinemia. This study aimed to analyze a group of jaundiced infants to assess the prevalence of UTI, explore potential risk factors, and examine the impact of UTI on the course and severity of neonatal jaundice.

Methods: This retrospective case-control study was conducted on 150 jaundiced infants (aged < 8 weeks) without a known etiology in the hyperbilirubinemia work-up. All subjects underwent phototherapy treatment and UTI screening by catheterization. They were then classified into UTI and non-UTI groups based on urine culture results, with a positive urine culture indicating the growth of ≥10,000 colony-forming units. The clinical characteristics and jaundice-related parameters of both groups were analyzed.

Results: Among the 150 jaundiced patients, the prevalence of UTI was 29%. There was a significantly higher male predominance in the UTI group, and patients with UTI also had a significantly longer duration of hospitalization compared to those without UTI. Significant risk factors associated with UTI in jaundiced infants included male gender and a peak total bilirubin level higher than 18 mg/dl during hospitalization. The most common pathogens identified in urine culture were Escherichia coli (41.9%) and Enterococcus faecalis (30.2%).

Conclusion: In cases of neonatal jaundice where the underlying cause is not evident, screening for UTI should be performed, particularly when associated risk factors or inadequate response to phototherapy is present.

Keywords: jaundice; neonatal hyperbilirubinemia; neonatal sepsis; phototherapy; urinary tract infections.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient selection process. UTI, urinary tract infection; CAKUT, congenital anomalies of the kidney and urinary tract.
Figure 2
Figure 2
Microorganisms isolated by catheterized urine culture in jaundiced infants with UTI. UTI, urinary tract infection.
See this image and copyright information in PMC

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