Urinary Tract Infections and Neonatal Jaundice

The aims of this study were to determine the incidence of UTI in asymptomatic jaundiced neonates in the first two weeks of life , and to determine which historical and laboratory parameters are associated with UTI in those neonates.The study included 153 full -term jaundiced neonates less than two weeks old who had been admitted in hospital for management of jaundice. Work-up for hyperbilirubinemia as well as urinalysis and urine culture were performed in all patients. Patients were considered to have UTI, if ≥100 000 colonyforming unit per ml of single pathogen was isolated from urine samples collected by urine bags. Sonography were requested to all cases with UTI Ten (6.5%) of 153 patients had UTI. The isolated organisms were E. coli (60%) followed by Klebsiella (30%) and Proteus (10%).There was no significant association between gender ,gestational age ,body weight, mode of feeding , total serum bilirubin(TSB) levels and UTI , but there was significant in onset of jaundice , direct (conjugated) bilirubin level and mean of decrease serum bilirubin level with phototherapy among neonates with and without UTI. One (10%)of 10 patients with UTI had abnormal ultrasound result. In conclusion, the study revealed that UTIs can occur in asymptomatic jaundiced neonates, and it seems better to perform urine cultures if they have high level of direct bilirubin ,onset of jaundice after 8 days of life and slow decrease in serum bilirubin level with phototherapy especially in male bottle-fed infants.