Department of Pediatrics, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27715, USA.
J Perinatol. 2013 Apr;33(4):302-6. doi: 10.1038/jp.2012.111. Epub 2012 Aug 30.
Urinary tract infections (UTI) are common in the neonatal intensive care unit (NICU). Blood, urine and cerebrospinal fluid (CSF) cultures are frequently obtained to evaluate for infection. We sought to determine the concordance between positive urine cultures and blood or CSF cultures.
Infants <121 days of age with a UTI admitted to 322 NICUs managed by the Pediatrix Medical Group from 1997 to 2010 were identified. UTIs were defined by isolation of a single pathogenic organism in a urine sample obtained by catheterization or suprapubic tap. The UTI was concordant if the same organism was identified in the blood or CSF within 3 days of the urine culture.
Of 5681 infants with a urine culture, 984 had 1162 UTIs. In total, 976 UTIs (84%) had a blood culture collected within 3 days, and 127 (13%) were concordant. Of the 1162 UTIs, 77 (7%) had a CSF culture collected within 3 days, and 2 (3%) were concordant.
Collection of a urine culture in infants evaluated for late-onset sepsis is important. Concordance was observed in 13% of blood cultures and 3% of CSF cultures. These findings may be related to the initiation of empirical antimicrobial therapy before evaluation for disseminated infection or poor blood culture sensitivity.
尿路感染（UTI）在新生儿重症监护病房（NICU）中很常见。为了评估感染情况，经常进行血液、尿液和脑脊液（CSF）培养。我们旨在确定阳性尿液培养与血液或 CSF 培养之间的一致性。
1997 年至 2010 年间，Pediatrix Medical Group 管理的 322 家 NICU 收治了<121 天龄、患有 UTI 的婴儿。UTI 的定义是通过导管或耻骨上穿刺获得的尿液样本中单一病原体的分离。如果在尿液培养后 3 天内血液或 CSF 中鉴定出相同的病原体，则 UTI 是一致的。
在 5681 例尿液培养的婴儿中，984 例有 1162 例 UTI。共有 976 例 UTI（84%）在 3 天内采集了血培养，其中 127 例（13%）是一致的。在 1162 例 UTI 中，77 例（7%）在 3 天内采集了 CSF 培养，其中 2 例（3%）是一致的。
在评估迟发性败血症的婴儿中进行尿液培养很重要。在 13%的血液培养和 3%的 CSF 培养中观察到一致性。这些发现可能与在评估播散性感染或血液培养敏感性差之前开始经验性抗菌治疗有关。
