Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital

Amelia, Novie; Amir, Idham; Trihono, Partini Pudjiastuti

doi:10.14238/pi45.5.2005.217-22

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…A detailed history and clinical examination was performed and the findings were recorded on predesigned questionnaire. Neonates presenting within 72 hours of life were grouped as early onset sepsis and after 72 hours of life were grouped as late onset sepsis 8 . All the neonates were investigated for sepsis with septic screen.…”

Section: Methodsmentioning

confidence: 99%

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A Study of Urinary Tract Infection in Neonatal Sepsis

N¹,

B²,

Paraskawar³

2014

jemds

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OBJECTIVE: Urinary Tract Infection (UTI) is an important clinical problem in the neonatal period. Early diagnosis and treatment of UTI is important. This study was undertaken to estimate the proportion of UTI in neonatal sepsis. METHODS: This prospective study included 207 neonates admitted with suspected sepsis. A detailed history and clinical examination was performed. Neonates presenting within 72 hours of life were grouped as early onset sepsis and after 72 hours of life were grouped as late onset sepsis. All the neonates were investigated for sepsis. Urine sample was collected by suprapubic aspiration and subjected to analysis and culture. Pyuria was defined by the presence of at least 5 leukocytes per high power field in a centrifuged sample and a positive urine culture-Bacterial growth of >1000 colony-forming units/ml was defined as UTI. RESULTS: Among the early onset sepsis group, 10.8% neonates had pyuria, of which 21.4% were culture positive. Among the late onset sepsis group, 44.2% neonates had pyuria, of which 35.3% were culture positive. Pyuria was more common in males (27.5%) than females (17.2%). Overall, culture positive UTI in EOS group was 2.3% and LOS group was 15.6% (p=0.001). Overall, the proportion of culture positive UTI in the entire study group was 7.2%. The most common causative organisms were E.Coli -53% followed by klebsiella-27%. CONCLUSION: It is very important to investigate for the UTI in newborns with sepsis especially late onset sepsis, as it can be easily missed. As congenital malformations of the urinary tract are also associated with UTI, it is essential to investigate for the same. Undiagnosed and/or inadequately treated UTI can lead to renal scarring, hypertension and end stage renal disease. This study highlights the need for routine urine analysis and culture, especially in newborns with late onset sepsis so they can be treated appropriately.

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Section: Methodsmentioning

confidence: 99%

“…The proportion of UTI in LOS group was 15.6% as compared to EOS which was only 2.3% (p=0.0003). Amelia N et al 8 17 . A few studies have also described low rates of positive blood cultures in neonates with positive urine cultures 16,[18][19][20] .…”

Section: Groupmentioning

confidence: 99%

A Study of Urinary Tract Infection in Neonatal Sepsis

N¹,

B²,

Paraskawar³

2014

jemds

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“…They can cause significant morbidity and long-term consequences include renal scarring, hypertension, and chronic renal failure [5,6]. Many pediatric UTI infections go undiagnosed due to a lack of specific symptoms and indications, particularly in newborns and young children [7]. It is believed that around 50% of UTIs in children are overlooked [8].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Etiology, Antimicrobial Susceptibility Testing and Predictors of Urinary Tract Infection among Neonates with Clinical Sepsis

Syed¹,

Rashid²,

Khan³

et al. 2023

PJMHS

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Background and Aim: The most common pediatric infection is urinary tract infection (UTI). Neonates who suffer from neonatal sepsis remain among the most vulnerable to death and morbidity, especially in developing countries. The present study aimed to determine the prevalence, etiology, and susceptible antimicrobial agents of UTIs among neonates with clinical sepsis. Patients and Methods: This cross-sectional study was carried out on 128 sepsis diagnosed neonates admitted to the Department of Pediatrics, Microbiology and Infectious Diseases, Niazi Welfare Teaching Hospital, Sargodha from September 2021 to May 2022. All neonates aged ≤ 28 days diagnosed of clinical sepsis and consent provided by their parents/guardian were enrolled. An interviewed based questionnaire was used for data collection from neonate’s parents or caregiver. The questionnaire included information on the socio-demographics and clinical presentations of neonates, as well as maternal history and laboratory examinations. The history is taken from prenatal to postnatal, including birth weight analysis and birth conditions. Neonates underwent general and local examinations to determine their state of consciousness, vital signs, and weight. We examined the abdomen (for tenderness and abdominal distention) and the nervous system (to elicit suckling and motor reflexes). A hematological analyzer was used to test the full blood picture (FBP). SPSS version 27 was used for data analysis. Results: Of the total 128 neonates, there were 76 (59.4%) females and 52 (40.6%) male neonates. The overall mean age was 6.4 ± 0.36 days with majority of neonates 112 (87.5%) were < 7 days. The low birth weight and low Apgar score were found in 13 (10.2%) and 16 (12.5%) neonates respectively. Of all neonates, the failure to breastfeed was found in 26 (20.3%) being the most common clinical symptom followed by an increase in breathing rate 21 (16.4%), diarrhea 19 (14.8%), gritting 16 (12.5%), altered mental status 12 (9.4%), and jaundice 11 (8.6%). The incidence of UTI was 20.3% (n=26). The prevalence of separated bacterial agents such as Klebsiella pneumonia and Enterobacter spp. was 61.5% (n=16) and 38.5% (n=10) respectively. Ciprofoxacin and amikacin were both effective against 90% and 60% of the bacterial isolates, respectively. The UTI potential predictors involved prolong labour, positive leucocyte esterase test, Low Apgar score, and positive urine nitrite test. Conclusion: The present study found that the prevalence of UTI was 20.3%. Failure to breastfeed was the most common clinical symptom followed by an increase in breathing rate, diarrhea, gritting, altered mental status, jaundice, convulsion, and cyanosis. Klebsiella pneumonia and Enterobacter spp. were the most prevalent separated bacterial agents. Ciprofoxacin and amikacin were both effective in bacterial isolates. Keywords: UTI, Clinical sepsis, Neonates, Antibiotic sensitivity

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Prevalence, aetiology, antimicrobial susceptibility testing, and predictors of urinary tract infection among neonates with clinical sepsis: a cross-sectional study

Lugira

Kimaro

Mkhoi

et al. 2022

Egypt Pediatric Association Gaz

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Background Urinary tract infection (UTI) is the most common and life-threatening bacterial infection among neonates. This study aimed to determine the prevalence, aetiology, and susceptible antimicrobial agents among neonates with UTI. Methods This was a cross-sectional analytical hospital-based study that included 152 neonates with clinical sepsis who were admitted at Dodoma regional referral hospital from January to June 2020. Bacterial growth of 1 × 103 colony forming units/mL of a single uropathogen was used to define the presence of UTI. Statistical analysis was performed using SPSS version 23.0 and multivariate analysis was used to determine the predicting factors of UTI. P <0.05 was regarded statistically significant. Results The prevalence of UTI was 18.4% (28/152). Klebsiella pneumoniae 64.3% (18/28) and Enterobacter spp. 35.7% (10/28) were the bacterial agents isolated. The bacterial isolates were 90%, and 60% sensitive to ciprofloxacin and amikacin, respectively. Low Apgar score (AOR = 12.76, 95% CI = 4.17–39.06, p<0.001), prolonged labour (AOR = 5.36, 95% CI = 1.28–22.52, p = 0.022), positive urine nitrite test (AOR = 26.67, 95% CI = 7.75–91.70, p<0.001), and positive leucocyte esterase test (AOR = 6.64, 95% CI = 1.47–29.97, p = 0.014) were potential predictors of UTI. Conclusion The prevalence of UTI confirmed by urine culture among neonates that were included in the present study indicates that this problem is common in the population where the study was conducted. Klebsiella pneumoniae and Enterobacter spp. were the uropathogens which were isolated. Ciprofloxacin, nitrofurantoin, and amikacin were sensitive to the isolated uropathogens.

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Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital

Cited by 3 publications

References 24 publications

A Study of Urinary Tract Infection in Neonatal Sepsis

A Study of Urinary Tract Infection in Neonatal Sepsis

Prevalence, Etiology, Antimicrobial Susceptibility Testing and Predictors of Urinary Tract Infection among Neonates with Clinical Sepsis

Prevalence, aetiology, antimicrobial susceptibility testing, and predictors of urinary tract infection among neonates with clinical sepsis: a cross-sectional study

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