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早期特发性新生儿黄疸与尿路感染之间的关联

Association Between Early Idiopathic Neonatal Jaundice and Urinary Tract Infections.

作者信息

Özcan Murat, Sarici S Ümit, Yurdugül Yüksel, Akpinar Melis, Altun Demet, Özcan Begüm, Serdar Muhittin A, Sarici Dilek

机构信息

Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ufuk University, Ankara, Turkey.

Department of Family Physicians, Ankara Training and Research Hospital, Ankara, Turkey.

出版信息

Clin Med Insights Pediatr. 2017 Mar 30;11:1179556517701118. doi: 10.1177/1179556517701118. eCollection 2017.

Abstract

BACKGROUND AND PURPOSE

Etiologic role, incidence, demographic, and response-to-treatment characteristics of urinary tract infection (UTI) among neonates, its relationship with significant neonatal hyperbilirubinemia, and abnormalities of the urinary system were studied in a prospective investigation in early (⩽10 days) idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia were ruled out.

PATIENTS AND METHODS

Urine samples for microscopic and bacteriologic examination were obtained with bladder catheterization from 155 newborns with early neonatal jaundice. Newborns with a negative urine culture and with a positive urine culture were defined as group I and group II, respectively, and the 2 groups were compared with each other.

RESULTS

The incidence of UTI in whole of the study group was 16.7%. Serum total and direct bilirubin levels were statistically significantly higher in group II when compared with group I ( = .005 and = .001, respectively). Decrease in serum total bilirubin level at the 24th hour of phototherapy was statistically significantly higher in group I compared with group II ( = .022).

CONCLUSIONS

Urinary tract infection should be investigated in the etiologic evaluation of newborns with significant hyperbilirubinemia. The possibility of UTI should be considered in jaundiced newborns who do not respond to phototherapy well or have a prolonged duration of phototherapy treatment.

摘要

背景与目的

在一项针对早期(≤10天)特发性新生儿黄疸的前瞻性研究中,排除了新生儿高胆红素血症的所有其他病因后,研究了新生儿尿路感染(UTI)的病因作用、发病率、人口统计学特征及治疗反应特征,及其与显著新生儿高胆红素血症和泌尿系统异常的关系。

患者与方法

通过膀胱插管从155例早期新生儿黄疸患儿获取尿液样本进行显微镜和细菌学检查。尿培养阴性和阳性的新生儿分别定义为I组和II组,并对两组进行比较。

结果

整个研究组UTI的发病率为16.7%。与I组相比,II组血清总胆红素和直接胆红素水平在统计学上显著更高(分别为P = .005和P = .001)。光疗24小时时I组血清总胆红素水平的下降在统计学上显著高于II组(P = .022)。

结论

在对有显著高胆红素血症的新生儿进行病因评估时应调查尿路感染。对于光疗反应不佳或光疗治疗持续时间延长的黄疸新生儿,应考虑UTI的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db43/5398657/11f6efeac7b8/10.1177_1179556517701118-fig1.jpg

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