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Screening of urinary Tract Infection in High-Risk Neonates

Journal of the Korean Pediatric Society 1992;35(12):1683-1679.
Published online December 15, 1992.
Screening of urinary Tract Infection in High-Risk Neonates
Hyeon Joo Choi, Seung Joo Lee
Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
고위험 신생아에서의 요로감염 선별검사에 대한 연구
최현주, 이승주
이화대학교 의과대학 소아과학교실
Since the urinary tract infection (UTI) in neonates is often associated with major urologic anomalies, early diagnosis is essential. In the screening of UTI by urine bag, contamination is a commonly encountered problem. Suprapubic bladder puncture has therefore been recommended as the best method to confirm UTI. The purpose of this study is to assess the frequency and characteristics of UTI in high-risk neonates and to decide whether the screening for bacteriuria is justified in this population. The results were as follows; 1) The incidence of UTI confirmed by suprapubic bladder aspirate was 1.9% among 792 high-risk neonates. 2) The false positive rates of the first and second bag urine culture were 89.5 and 87.5%, respectively. 3) The incidence of UTI in male neonates was 2.8%, significantly higher than 0.6% of females (p<0.05). The incidence in symptomatic neonates was 3.6%, significantly higher than 0.8% of asymptomatic neonates (p<0.05). The incidence in asymptomatic preterm neonates was 5.1%, significantly higher than 0.2% of asymptomatic term neonates. 4) Fever, not doing well, vomiting or diarrhea, respiratory symptoms in order were the major symptoms with the high incidence of UTI. 5) Urinary imaging in 13 UTI showed abnormalities in 5 males, 1 UPJ obstruction, 3 VUR, and 1 renal candidiasis. In conclusion, high-risk neonates especially males, preterms, symptomatic neonates might be beneficial if screened for UTI, and performed urinary imaging in proven UTI.
Key Words: Urinary tract infection, Suprapubic bladder puncture

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