Do Systemic Inflammatory Indices, Urinalysis, and Radiological Findings Vary by Causative Pathogen in Neonatal Urinary Tract Infections?

Abstract

Objectives Urinary tract infections (UTI) are the most common occult infections in infants under three months of age with high fever, caused by various pathogens, and can progress with different symptoms from mild to severe. We planned to explore and compare pathogen-specific systemic inflammatory indices, urinalysis, and radiological findings in newborns.

Methods The retrospective study included preterm and term neonates with single pathogen growth of≥50.000 colony-forming units (CFU) /mL from urine cultures obtained by first-time catheterization between September 2019 and November 2021. Baseline hemogram parameters, acute phase reactants, systemic inflammatory indexes, urinalysis, and radiological findings were analyzed in pathogen-specific groups.

Results Of the 132 patients included in the study, gastrointestinal symptoms were the most common. C-reactive protein values were higher in the non- E. Coli group (p<0.05). Procalcitonin values were higher in patients with Klebsiella spp. isolates (p<0.05). Systemic inflammatory indexes were higher in patients with Coagulase-Negative Staphylococci isolates (p<0.05). Urinary acidity was higher in the non-E. Coli group (p<0.05). Escherichia Coli and Klebsiella Spp. were isolated in two-thirds of patients with leukocyte esterase positivity. The most common cause of UTI in patients with abnormal renal ultrasound findings was E. Coli (33.3%).

Conclusion Our findings imply that unconventional tests could assist in pathogen differentiation, determining clinical presentation, and prognosis.

Zusammenfassung

Ziele Harnwegsinfektionen (HWI) sind die häufigsten okkulten Infektionen bei Säuglingen unter drei Monaten mit hohem Fieber, die durch verschiedene Krankheitserreger verursacht werden und mit unterschiedlichen Symptomen von leicht bis schwer verlaufen können. Wir wollten erregerspezifische systemische Entzündungsindizes, Urinanalysen und radiologische Befunde bei Neugeborenen untersuchen und vergleichen.

Methoden Die retrospektive Studie umfasste Früh- und Reifgeborene mit einem Einzelpathogenwachstum von≥50.000 koloniebildenden Einheiten (KBE)/ml aus Urinkulturen, die zwischen September 2019 und November 2021 durch erstmalige Katheterisierung gewonnen wurden. Ausgangshämogrammparameter, Akute-Phase-Reaktanten, Systemische Entzündungsindizes, Urinanalyse und radiologische Befunde wurden in erregerspezifischen Gruppen analysiert.

Ergebnisse Von den 132 in die Studie einbezogenen Patienten waren Magen-Darm-Beschwerden am häufigsten. Die Werte für C-reaktives Protein waren in der Nicht-E.-Coli-Gruppe höher (p<0,05). Bei Patienten mit Klebsiella Spp. waren die Procalcitoninwerte höher. Isolate (p<0,05). Bei Patienten mit Koagulase-negativen Staphylokokken-Isolaten waren die systemischen Entzündungsindizes höher (p<0,05). Der Säuregehalt im Urin war bei Nicht-E-Patienten höher. Coli-Gruppe (p<0,05). Escherichia Coli und Klebsiella Spp. wurden bei zwei Dritteln der Patienten mit Leukozytenesterase-Positivität isoliert. Die häufigste Ursache für Harnwegsinfektionen bei Patienten mit abnormalen Nierenultraschallbefunden war E. Coli (33,3%).

Schlussfolgerung Unsere Ergebnisse deuten darauf hin, dass unkonventionelle Tests bei der Differenzierung von Krankheitserregern, der Bestimmung des klinischen Erscheinungsbilds und der Prognose hilfreich sein könnten.

Keywords

neonate - urinary tract infection - systemic inflammatory indexes - Escherichia coli - klebsiella pneumoniae

Schlüsselwörter

Neugeborene - Harnwegsinfektion - Systemische Entzündungsindizes - Escherichia coli - Klebsiella pneumoniae

Publication History

Article published online:
10 December 2024

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