Department of Pediatrics, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2011 Apr;74(4):159-63. doi: 10.1016/j.jcma.2011.01.036.
Hyperbilirubinemia is one of the most common causes for hospital admission in neonatal infants. Previous studies have found that jaundice may be one of the initial symptoms related to urinary tract infection (UTI) in infants. This study is to evaluate the incidence and related factors of neonatal infants with the initial presentation of hyperbilirubinemia and final diagnosis of UTI in a tertiary teaching hospital.
We retrospectively investigated the medical records of admitted infants younger than 8 weeks old with hyperbilirubinemia between January and December 2008. The jaundiced infants having tests of urinalysis were enrolled into our study and grouped into UTI or no UTI group according to the findings of urinary culture.
A total of 217 neonatal jaundiced infants were enrolled. Among them, 12 cases (5.5%) were grouped into the UTI group, and the most common cultured bacterium from their urine was Escherichia coli. There was no significant difference in the babies' birth weight, maternal conditions, or total bilirubin levels between the two groups. There was also no significant difference between the two groups in their admission age (9.7 ± 13.5 days vs. 6.1 ± 6.7 days in UTI and no UTI groups, respectively) or the ratio of outpatients (50% vs. 25% in UTI and no UTI groups, respectively) (p > 0.05). The cases of UTI group had significantly lower hemoglobin (15.2 ± 2.7 g/dL vs. 17.2 ± 2.3 g/dL, respectively) and higher formula feeding rate (8.3% vs. 2.9%, respectively) than the no UTI group (p < 0.05).
The incidence of UTI in the admitted infants with hyperbilirubinemia was as high as approximately 5.5%. The most common cultured bacterium in urine was E coli. Therefore, performing urinary tests to exclude the possibility of coincidental UTI may be necessary for admitted jaundiced infants younger than 8 weeks old.
高胆红素血症是新生儿住院的最常见原因之一。先前的研究发现，黄疸可能是婴儿尿路感染（UTI）的初始症状之一。本研究旨在评估在一家三级教学医院中，以高胆红素血症为初始表现且最终诊断为 UTI 的新生儿的发病率和相关因素。
我们回顾性调查了 2008 年 1 月至 12 月期间在我院住院的小于 8 周龄高胆红素血症婴儿的病历。对接受尿液分析检查的黄疸婴儿进行了研究，并根据尿液培养结果将其分为 UTI 组或非 UTI 组。
共纳入 217 例新生儿黄疸婴儿。其中，12 例（5.5%）归入 UTI 组，尿液培养最常见的细菌为大肠杆菌。两组婴儿的出生体重、产妇情况或总胆红素水平无显著差异。两组婴儿的入院年龄（分别为 UTI 组 9.7±13.5 天和非 UTI 组 6.1±6.7 天）或门诊就诊比例（分别为 UTI 组 50%和非 UTI 组 25%）也无显著差异（p＞0.05）。UTI 组的血红蛋白水平（15.2±2.7 g/dL）明显低于非 UTI 组（17.2±2.3 g/dL），配方奶喂养率（8.3%）明显高于非 UTI 组（2.9%）（p＜0.05）。
以高胆红素血症入院的婴儿中 UTI 的发病率高达约 5.5%。尿液中最常见的培养细菌为大肠杆菌。因此，对于小于 8 周龄的入院黄疸婴儿，可能需要进行尿液检查以排除偶然发生的 UTI 的可能性。
