Hemolysis due to gram-negative urinary tract infection.

Twenty-four infants 8--62 days of age with urinary tract infection have presented with a chief complaint of jaundice. The bilirubin determinations have ranged from 6--48.2 mg/dl, with elevation of both the direct and indirect reacting bilirubin fractions except for the youngest infants (under 10 days old), where only indirect bilirubin elevation was present. The BUNs ranged from 18--153 mg/dl with general correlation to the bilirubin elevation. Hemolysis was documented in 21 infants. The infecting organisms were predominantly Escherichia coli (20 patients) of the low-number serotypes. We have been able to test 11 of the isolates and have found that all produced hemolysis on blood agar plates. Another interesting observation has been the reversal of the expected frequency of the A and B blood groups in our series. There is an excessive number of infants of blood group B with a paucity of blood group A; blood group O is as expected. The relationship of blood group type and E. coli infection and the presence or absence of jaundice needs to be explored in a larger group of infants.