Urinary Tract Infections in Hospitalized Newborns in Beheshti Hospital, Iran: A Retrospective Study

Early diagnosis and proper treatment including long-term follow-up are crucial in management of neonatal urinary tract infections (UTIs). To determine the pathogens responsible for UTI in newborns and the antibiotic susceptibility of these organisms, all medical records of 3,623 hospitalized newborns in the neonatal unit of Beheshti Hospital, Kashan, Iran, during a five-year period from April 2000 to March 2005 who developed UTIs were retrospectively reviewed. Urine specimen was obtained by a suprapubic bladder aspiration. Our results showed that 38 of 3,623 (1.04%) newborns had UTI. The mean age of these newborns was 8.1 days (range: 1-28 days), and 15 of them (39.5%) were less than 7 days old. UTI associated with septicemia was observed in 10.5 percent of them. Seven of 38 (18.4%) newborns were preterm, and 27 of them were boys. The most common clinical findings was jaundice which occurred in 68.4 percent of these newborns. Escherichia coli were the most common isolated organism. E. coli isolates were most susceptible to amikacin and gentamicin (5.2%), but were most resistant to cephalexin (78.9%). Cephalexin-resistant Gram-negative bacteria were the most common cause of UTI in infants of less than 29 days old. Our findings would impact clinicians in choosing appropriate empirical antibiotic for the treatment of UTI before obtaining the microbiologic results based on local surveillance of causative pathogens of UTIs and antibiotic susceptibility patterns. (J Infect Dis Antimicrob Agents 2007;24:7-11.) *Department of Pediatrics, Kashan University of Medical Sciences and Health Services, Kashan, Iran. ** Department of Neonatology, Kashan University of Medical Sciences and Health Services, Kashan, Iran. *** Department of Microbiology, Kashan University of Medical Sciences and Health Services, Kashan, Iran. Received for publication: November 9, 2006. Reprint request: Rezvan Moniri, D.V.M., Ph.D., Associate Professor of Microbiology, Kashan University of Medical Sciences, P.O. Box: 87155.111, Kashan, Iran. E-mail: [email protected]