Urinary tract infection and neonatal hyperbilirubinemia.

I have read with great interest the article by Bilgen et al., which appeared in the last issue [2006; 48 (1)] of the journal. The relationship (reason or result) between neonatal, especially prolonged hyperbilirubinemia and urinary tract infection is highly questionable, and investigation and debate on the topic are ongoing1,2. However, there are some methodological and propositional question marks in the authors’ study, which should be noted and highlighted. The authors aimed to investigate the incidence of urinary tract infection (UTI) in newborns with asymptomatic and unexplained indirect hyperbilirubinemia in the first two weeks of life. However, although the cases included in the study were stratified according to “hyperbilirubinemia” (inclusion criterion), grouping (main outcome measuring; Groups 1 and 2) was made on the basis of urine culture positivity. Thus, in the methodological design of the study in the conclusion, cases with and without urine culture positivity were compared with respect to various parameters, including early and late hyperbilirubinemia, instead of comparing newborns with and without hyperbilirubinemia on the basis of whether they have or do not have a UTI.