Urinary tract infection in term neonates with prolonged jaundice.

The aim of this study was to evaluate the frequency of urinary
tract infection (UTI) in neonates with prolonged jaundice.
Materials and Methods: Newborn infants with jaundice lasted more than 2
weeks were included in this study. Patients who had other signs or symptoms were
excluded. Workup of prolonged hyperbilirubinemia was performed, including
direct Coomb’s test, blood group of the neonate and the mother, complete blood
count, blood smear, glucose-6-phosphate dehydrogenase (G6PD), reticulocyte
count, serum level of bilirubin (unconjugated and conjugated), thyroid function
tests (serum thyroxine [T4] and thyroid-stimulating hormone), urinalysis, and
suprapubic urine culture. Pediatric nephrologists carried out further investigation
including kidney function tests, renal ultrasonography, voiding cystourethrography,
and Technetium Tc 99m dimercaptosuccinic acid renal scintigraphy for patients
with a positive urine culture for microorganisms.
Results: Of 100 neonates who were evaluated, 43 were boys and 57 were girls.
All of the neonates were breastfed. Six suffered from UTI (4 boys and 2 girls).
Reflux was detected on voiding cystourethrography in 1 and cortical defect in the
kidney on renal scan in 2 boys.
Conclusion: In our region, with a high rate of breastfeeding, UTI remains as an
important cause of prolonged jaundice. Despite the high rate of urogenital system
abnormality accompanied by neonatal UTI, there was not a significant difference
between the signs and symptoms of jaundice in patients with and without UTI.
Performing urine cultures should be considered as a routine procedure in the
evaluation of every infant with prolonged jaundice.