Urinary tract infections in very low birthweight infants: A two-center analysis of microbiology, imaging and heart rate characteristics
| Autor: | Noelia Aviles-Otero, Meaghan Ransom, Brynne A. Sullivan, Jennifer R. Charlton, Karen D. Fairchild, David A. Kaufman, Joern-Hendrik Weitkamp |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Time Factors medicine.drug_class Urinary system Antibiotics Urine urologic and male genital diseases Vesicoureteral reflux law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Heart Rate law 030225 pediatrics Heart rate medicine Humans Infant Very Low Birth Weight 030212 general & internal medicine Hydronephrosis Renal ultrasounds Retrospective Studies Ultrasonography business.industry Infant bacterial infections and mycoses medicine.disease female genital diseases and pregnancy complications Urinary Tract Infections Pediatrics Perinatology and Child Health business |
| Zdroj: | Journal of Neonatal-Perinatal Medicine. 14:269-276 |
| ISSN: | 1878-4429 1934-5798 |
| DOI: | 10.3233/npm-200513 |
| Popis: | BACKGROUND: Increased understanding of characteristics of urinary tract infection (UTI) among very low birthweight infants (VLBW) might lead to improvement in detection and treatment. Continuous monitoring for abnormal heart rate characteristics (HRC) could provide early warning of UTIs. OBJECTIVE: Describe the characteristics of UTI, including HRC, in VLBW infants. METHODS: We reviewed records of VLBW infants admitted from 2005–2010 at two academic centers participating in a randomized clinical trial of HRC monitoring. Results of all urine cultures, renal ultrasounds (RUS), and voiding cystourethrograms (VCUG) were assessed. Change in the HRC index was analyzed before and after UTI. RESULTS: Of 823 VLBW infants (27.7±2.9 weeks GA, 53% male), 378 had > / = 1 urine culture obtained. A UTI (≥10,000 CFU and >five days of antibiotics) was diagnosed in 80 infants, (10% prevalence, mean GA 25.8±2.0 weeks, 76% male). Prophylactic antibiotics were administered to 29 (36%) infants after UTI, of whom four (14%) had another UTI. Recurrent UTI also occurred in 7/51 (14%) of infants not on uroprophylaxis after their first UTI. RUS was performed after UTI in 78%, and hydronephrosis and other major anomalies were found in 19%. A VCUG was performed in 48% of infants and 18% demonstrated vesicoureteral reflux (VUR). The mean HRC rose and fell significantly in the two days before and after diagnosis of UTI. CONCLUSIONS: UTI was diagnosed in 10% of VLBW infants, and the HRC index increased prior to diagnosis, suggesting that continuous HRC monitoring in the NICU might allow earlier diagnosis and treatment of UTI. |
| Databáze: | OpenAIRE |
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