Chen Ing, Hsu Li-Sang, Yao Cai-Sin, Chang Jenn-Tzong, Wang Hsiao-Ping, Fang Nai-Wen
Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan.
Front Pediatr. 2024 Jan 25;12:1332052. doi: 10.3389/fped.2024.1332052. eCollection 2024.
Urinary tract infection (UTI) is a potential cause of neonatal jaundice. Nevertheless, there remains a lack of consensus regarding appropriate screening practices for UTI in infants with hyperbilirubinemia. This study aimed to analyze a group of jaundiced infants to assess the prevalence of UTI, explore potential risk factors, and examine the impact of UTI on the course and severity of neonatal jaundice.
This retrospective case-control study was conducted on 150 jaundiced infants (aged < 8 weeks) without a known etiology in the hyperbilirubinemia work-up. All subjects underwent phototherapy treatment and UTI screening by catheterization. They were then classified into UTI and non-UTI groups based on urine culture results, with a positive urine culture indicating the growth of ≥10,000 colony-forming units. The clinical characteristics and jaundice-related parameters of both groups were analyzed.
Among the 150 jaundiced patients, the prevalence of UTI was 29%. There was a significantly higher male predominance in the UTI group, and patients with UTI also had a significantly longer duration of hospitalization compared to those without UTI. Significant risk factors associated with UTI in jaundiced infants included male gender and a peak total bilirubin level higher than 18 mg/dl during hospitalization. The most common pathogens identified in urine culture were (41.9%) and (30.2%).
In cases of neonatal jaundice where the underlying cause is not evident, screening for UTI should be performed, particularly when associated risk factors or inadequate response to phototherapy is present.
尿路感染（UTI）是新生儿黄疸的一个潜在病因。然而，对于高胆红素血症婴儿的UTI合适筛查方法仍缺乏共识。本研究旨在分析一组黄疸婴儿，以评估UTI的患病率，探索潜在危险因素，并研究UTI对新生儿黄疸病程和严重程度的影响。
本回顾性病例对照研究针对150例黄疸婴儿（年龄<8周）进行，这些婴儿在高胆红素血症检查中无已知病因。所有受试者均接受光疗治疗并通过导尿进行UTI筛查。然后根据尿培养结果将他们分为UTI组和非UTI组，尿培养阳性表明菌落形成单位≥10,000个。分析了两组的临床特征和黄疸相关参数。
在150例黄疸患者中，UTI的患病率为29%。UTI组男性占比明显更高，与非UTI患者相比，UTI患者的住院时间也明显更长。黄疸婴儿中与UTI相关的显著危险因素包括男性以及住院期间总胆红素峰值高于18mg/dl。尿培养中鉴定出的最常见病原体为（41.9%）和（30.2%）。
在新生儿黄疸病因不明的情况下，应进行UTI筛查，尤其是存在相关危险因素或对光疗反应不佳时。
