Urinary tract infection in the newborn: clinical and radio imaging studies |
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Authors: | José B. López Sastre Antonio Ramos Aparicio Gil D. Coto Cotallo Belén Fernández Colomer Manuel Crespo Hernández Grupo de Hospitales Castrillo |
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Affiliation: | (1) Service of Neonatology, Department of Paediatrics, Hospital Universitario Central de Asturias, Celestino Villamil s/n, E-33006 Oviedo Asturias, Spain |
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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 >or=10(4) 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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Keywords: | Vesicoureteral reflux Hydronephrosis Renal ultrasound Voiding cystourethrography Renal scan with dimercaptosuccinic acid Neonates Community-acquired urinary tract infection Nosocomial urinary tract infection |
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