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高胆红素血症新生儿尿路感染的早期预测

Early prediction of urinary tract infection in neonates with hyperbilirubinemia.

作者信息

Nickavar Azar, Khosravi Nastaran, Doaei Mahdiye

机构信息

Department of Pediatric Nephrology, Iran University Medical Sciences, Tehran, Iran.

Department of Neonatology, Iran University Medical Sciences, Tehran, Iran.

出版信息

J Renal Inj Prev. 2015 Sep 1;4(3):92-5. doi: 10.12861/jrip.2015.18. eCollection 2015.

Abstract

INTRODUCTION

Hyperbilirubinemia is a common manifestation of infectious disorders during the neonatal period. Urinary tract infection (UTI) is one of the serious bacterial infections with hyperbilirubinemia among newborn infants.

OBJECTIVES

The aim of this study was to identify the early predictive risk factors of UTI in neonates with hyperbilirubinemia, to prevent its long-term complications.

PATIENTS AND METHODS

A total of 95 neonatal hyperbilirubinemia were evaluated in 2 groups with (n = 40) and without UTI (n = 55).

RESULTS

Mean age at diagnosis of UTI was 16.37 ± 8.86 days. Hyperbilirubinemia was detected in 70% of patients during the first week of life. There was a significant difference regarding the age at admission, duration of hyperbilirubinemia, serum bilirubin and creatinine, white blood cells (WBC) , and also Hgb levels between the 2 groups in univariate analysis. However, prolonged jaundice (OR = 10.3, P = 0.001) and serum bilirubin concentration (OR = 5.15, P = 0.001) were statistically associated with a positive urine culture in multivariate analysis.

CONCLUSION

Screening of UTI is recommended in neonates with prolonged unexplained jaundice, leukocytosis, and increased serum creatinine.

摘要

引言

高胆红素血症是新生儿期感染性疾病的常见表现。尿路感染(UTI)是新生儿中伴有高胆红素血症的严重细菌感染之一。

目的

本研究的目的是确定高胆红素血症新生儿尿路感染的早期预测危险因素,以预防其长期并发症。

患者与方法

共对95例新生儿高胆红素血症患者进行评估,分为两组,一组有尿路感染(n = 40),另一组无尿路感染(n = 55)。

结果

尿路感染诊断时的平均年龄为16.37±8.86天。70%的患者在出生后第一周检测到高胆红素血症。单因素分析显示,两组在入院年龄、高胆红素血症持续时间、血清胆红素和肌酐、白细胞(WBC)以及血红蛋白(Hgb)水平方面存在显著差异。然而,多因素分析显示,黄疸持续时间延长(OR = 10.3,P = 0.001)和血清胆红素浓度(OR = 5.15,P = 0.001)与尿培养阳性在统计学上相关。

结论

建议对黄疸持续时间不明、白细胞增多和血清肌酐升高的新生儿进行尿路感染筛查。

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Urinary tract infection in the newborn: clinical and radio imaging studies.新生儿尿路感染:临床与影像学研究
Pediatr Nephrol. 2007 Oct;22(10):1735-41. doi: 10.1007/s00467-007-0556-5. Epub 2007 Jul 31.

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