Pediatric Nephrology

, Volume 22, Issue 10, pp 1735–1741

Urinary tract infection in the newborn: clinical and radio imaging studies

  • José B. López Sastre
  • Antonio Ramos Aparicio
  • Gil D. Coto Cotallo
  • Belén Fernández Colomer
  • Manuel Crespo Hernández
  • Grupo de Hospitales Castrillo
Original Article

DOI: 10.1007/s00467-007-0556-5

Cite this article as:
López Sastre, J.B., Ramos Aparicio, A., Coto Cotallo, G.D. et al. Pediatr Nephrol (2007) 22: 1735. doi:10.1007/s00467-007-0556-5

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 ≥104 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.

Keywords

Vesicoureteral refluxHydronephrosisRenal ultrasoundVoiding cystourethrographyRenal scan with dimercaptosuccinic acidNeonatesCommunity-acquired urinary tract infectionNosocomial urinary tract infection

Copyright information

© IPNA 2007

Authors and Affiliations

  • José B. López Sastre
    • 1
  • Antonio Ramos Aparicio
    • 1
  • Gil D. Coto Cotallo
    • 1
  • Belén Fernández Colomer
    • 1
  • Manuel Crespo Hernández
    • 1
  • Grupo de Hospitales Castrillo
  1. 1.Service of Neonatology, Department of PaediatricsHospital Universitario Central de AsturiasAsturiasSpain