Proportion of Urinary Tract Infection in Neonatal Sepsis

Background and Aim: Urinary tract infection (UTI) might be associated with bacteremia and congenital anomalies of the kidney and urinary tract (CAKUT) in neonates, which can lead to renal parenchymal scarring and chronic kidney disease in complicated situations. We aimed to determine the occurrence of UTI in neonatal sepsis. Methods: A cross-sectional study was conducted on 500 term extramural hospitalized neonates suspected to have infection. They underwent a detailed history, physical examination, and comprehensive sepsis workup. The diagnosis of neonatal UTI was based on a positive urine culture obtained by suprapubic aspiration (SPA). Results: Out of 500 neonates included in our study (324 boys and 176 girls), blood culture was positive in 84 (36.5%) neonates in the early onset sepsis group (n=230) and in 130 (48.1%) neonates in late onset sepsis group (n=270) (p < 0.05). In both early onset sepsis (EOS) and late onset sepsis (LOS) groups, blood culture was found to be positive in a greater proportion of male (41.3%) versus female (29.3%) patients (p <0.05). The most common organism isolated from blood and urine culture was Klebsiella followed by E-coli. Urine culture was positive in 34 (6.8%) patients of whom 29 (85%) culture positive cases were from the LOS group (p <0.05). Conclusion: UTI is not uncommon among the hospitalized neonates, and UTI evaluation among septic neonates can prove beneficial for the prevention of long-term sequelae of neonatal UTI.