Urinary tract infection profile among a hospitalized newborn: a single center study in Iran, 2006-2015

  • Mohammad K. Sabzehei Department of Pediatrics, Hamedan University of Medical Sciences, Hamedan
  • Behnaz Basiri Department of Pediatrics, Hamedan University of Medical Sciences, Hamedan
  • Maryam Shokouhi Department of Pediatrics, Hamedan University of Medical Sciences, Hamedan
  • Fatemeh Eghbalian Department of Pediatrics, Hamedan University of Medical Sciences, Hamedan
Keywords: clinical signs, neonates, type of organism, urinary tract infection
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Background: Urinary tract infection in infants is associated with septicemia and genitourinary anomalies. This study was aimed at investigating the frequency, clinical signs, and anomalies in infants hospitalized for urinary tract infection.

Methods: This cross-sectional study was conducted on all infants with urinary infection who were hospitalized in the neonatal ward of Beâsat Hospital from 2006 to 2015.

Results: Of 79 infants with urinary infection, 62% were male and 87.3% were term infants. The mean age at admission was 16.62±7.17 days, and the mean weight was 3276±478.23 grams. The most frequent clinical sign and the most common pathogen reported were prolonged jaundice (62%) and Escherichia coli (69.6%), respectively. Of the samples, 93.7% were obtained by suprapubic aspiration, 23% had leukocytosis, and 2.5% had urosepsis. In urinalysis examination, 81% had pyuria and 19% had positive nitrate. Among 25.3% infants who had abnormal ultrasound findings, the most abnormal finding was mild bilateral hydronephrosis and 6.3% of the infants had abnormal voiding cystourethrogram (VCUG) in which vesicoureteral reflux was the most frequent finding.

Conclusion: It showed that a prolonged jaundice in infants should be considered as a strong factor predicting urinary tract infection.


  1. Bagga A, Tripathi P, Jatana V, Hari P, Kapil A, Srivastava RN, et al. Bacteriuria and urinary tract infections in malnourished children. Pediatr Nephrol. 2003;18(4):366-70. https://doi.org/10.1007/s00467-003-1118-0

  2. Riskin A, Toropine A, Bader D, Hemo M, Srugo I, Kugelman A. Is it justified to include urine cultures in early (<72 hours) neonatal sepsis evaluations of term and late preterm infants? Am J Perinatol. 2013;30(06):499-504. https://doi.org/10.1055/s-0032-1329180

  3. Bonadio W, Maida G. Urinary tract infection in outpatient febrile infants younger than 30 days of age: a 10-year evaluation. Pediatr Infect Dis J. 2014;33(4):342-4. https://doi.org/10.1097/INF.0000000000000110

  4. Garcia FJ, Nager AL. Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics. 2002;109(5):846-51. https://doi.org/10.1542/peds.109.5.846

  5. Wiswell TE, Geschke DW. Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics. 1989;83(6):1011-5.

  6. Goldman M, Lahat E, Strauss S, Reisler G, Livne A, Gordin L, et al. Imaging after urinary tract infection in male neonates. Pediatrics. 2000;105(6):1232-5. https://doi.org/10.1542/peds.105.6.1232

  7. Cataldi L, Zaffanello M, Gnarra M, Fanos V, Neonatal Nephrology Study Group, Italian Society of Neonatology. Urinary tract infection in the newborn and the infant: state of the art. J Matern Fetal Neonatal Med. 2010;23(sup3):90-3. https://doi.org/10.3109/14767058.2010.513851

  8. Downs SM. Technical report: urinary tract infections in febrile infants and young children. Pediatrics. 1999;103(4). https://doi.org/10.1542/peds.103.4.e54

  9. Herreros Fernández ML, González Merino N, Taqarro García A, Pérez Seoane B, de la Serna Martínez M, Contreras Abad MT, et al. A new technique for fast and safe collection of urine in newborns. Arch Dis Child. 2013;98(1):27-9. https://doi.org/10.1136/archdischild-2012-301872

  10. Wiswell TE, Hachey WE. Urinary tract infections and the uncircumcised state: an update. Clin Pediatr. 1993;32(3):130-4. https://doi.org/10.1177/000992289303200301

  11. Youssef DM, Elfateh HA, Sedeek R, Seleem S. Epidemiology of urinary tract infection in neonatal intensive care unit: a single center study in Egypt. J Acad Med Sci. 2012;2(1):25-9. https://doi.org/10.4103/2249-4855.104012

  12. Nickavar A, Khosravi N, Doaei M. Early prediction of urinary tract infection in neonates with hyperbilirubinemia. J Renal Inj Prev. 2015;4(3):92-5. https://doi.org/10.12861/jrip.2015.18

  13. Milani Hosseini S, Ataei N, Khalafi F, Sheikhvatan M. Incidence of urinary tract infection in neonates with septicemia: a prospective study. Minerva Pediatr. 2011;63(5):369-73.

  14. Littlewood JM. 66 infants with urinary tract infection in first month of life. Arch Dis Child. 1972;47(252):218-26. https://doi.org/10.1136/adc.47.252.218

  15. Sharif M, Madani M, Kheirkhah D. Urinary tract infection in icteric infants younger than one week. KAUMS Journal (FEYZ). 2014;18(4):383-8.

  16. Khalesi N, Sharaki T, Haghigh M. Prevalence of urinary tract infection in neonates with prolonged jaundice referred to Aliasghar hospital in Zahedan (2005). J Qazvin Univ Med Sci. 2007;11(3):14-8.

  17. Hematyar M, Emami P. Incidence of urinary tract infection in hospitalized icteric neonates in Javaheri hospital (2003-2006). J Med Counc Islam Repub Iran. 2009;27(3):343-8.

  18. Désinor OY, Silva JL, Ménos MJ. Neonatal sepsis and meningitis in Haiti. J Trop Pediatr. 2004;50(1):48-50. https://doi.org/10.1093/tropej/50.1.48

  19. Hajebrahim Tehrani F, Valaie N. Incidence of septicemia and urinary tract infection in newborns with jaundice hospitalized in Mofid hospital. KAUMS Journal (FEYZ). 2004;7(4):58-63.

  20. Zaidi AK, Huskins WC, Thaver D, Bhutta ZA, Abbas Z, Goldmann DA. Hospital-acquired neonatal infections in developing countries. Lancet. 2005;365(9465):1175-88. https://doi.org/10.1016/S0140-6736(05)71881-X

  21. Downey LC, Benjamin Jr DK, Clark RH, Watt KM, Hornik CP, Laughon MM, et al. Urinary tract infection concordance with positive blood and cerebrospinal fluid cultures in the neonatal intensive care unit. J Perinatol. 2013;33(4):302-6. https://doi.org/10.1038/jp.2012.111

  22. Tamim MM, Alesseh H, Aziz H. Analysis of the efficacy of urine culture as part of sepsis evaluation in the premature infant. Pediatr Infect Dis J. 2003;22(9):805-8. https://doi.org/10.1097/01.inf.0000083822.31857.43

  23. Eliakim A, Dolfin T, Korzets Z, Wolach B, Pomeranz A. Urinary tract infection in premature infants: the role of imaging studies and prophylactic therapy. J Perinatol. 1997;17(4):305-8.

  24. Boskabadi H, Maamouri G, Mafinejad S, Rezagholizadeh F. Clinical course and prognosis of hemolytic jaundice in neonates in North East of Iran. Maced J Med Sci. 2011;4(4):403-7. https://doi.org/10.3889/MJMS.1857-5773.2011.0177

  25. Sastre JB, Aparicio AR, Cotallo GD, Colomer BF, Hernández MC, de Hospitales Castrillo G. Urinary tract infection in the newborn: clinical and radio imaging studies. Pediatr Nephrol. 2007;22(10):1735-41. https://doi.org/10.1007/s00467-007-0556-5

  26. Eghbalian F, Monsef AR. Prolonged jaundice as an early manifestation of asymptomatic urinary tract infection. J Urmia Univ Med Sci. 2009;20(2):98-103.

  27. Huang YS, Wang SM, Liu CC, Yang YJ. Invasive Escherichia coli infection in infancy: clinical manifestation, outcome, and antimicrobial susceptibility. J Microbiol Immunol Infect . 2002;35(2):103-8.

  28. Crain EF, Gershel JC. Urinary tract infections in febrile infants younger than 8 weeks of age. Pediatrics. 1990;86(3):363-7.

  29. Ismaili K, Lolin K, Damry N, Alexander M, Lepage P, Hall M. Febrile urinary tract infections in 0-to 3-month-old infants: a prospective follow-up study. J Pediatr. 2011;158(1):91-4. https://doi.org/10.1016/j.jpeds.2010.06.053

  30. Rahman AJ, Naz F, Ashraf S. Significance of pyuria in the diagnosis of urinary tract infections in neonates. J Pak Med Assoc. 2011;61(1):70-3.

  31. Bachur R, Harper MB. Reliability of the urinalysis for predicting urinary tract infections in young febrile children. Arch Pediat Adol Med. 2001;155(1):60-5. https://doi.org/10.1001/archpedi.155.1.60

How to Cite
Sabzehei MK, Basiri B, Shokouhi M, Eghbalian F. Urinary tract infection profile among a hospitalized newborn: a single center study in Iran, 2006-2015. Med J Indones [Internet]. 2018Sep.9 [cited 2023Feb.5];27(2):94–100. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/2677
Clinical Research