Frequency and prevention of recurrent Urinary Tract Infections (UTI) in hospitalized infants

D. L. Cason, B. S. Carter, Jatinder J Bhatia

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: We investigated the frequency and prevention of recurrent UTI in infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU). METHODS: A retrospective review of all male infants admitted to the NICU from June 1996-September 1998 revealed 31/595 males with UTI. Infants were divided into 3 Groups: A1 < 37 weeks with 1 UTI, A2 < 37 weeks with >1 UTI, and B ≥37 weeks with any UTI. Gestational age, birth weight, age at diagnosis of UTI, microorganisms, follow-up care (including imaging studies) and recurrence rates prior to discharge were determined. The effect of circumcision on recurrence of UTI was also investigated. RESULTS: Thirty-one infants had 44 UTIs during the study period (5.2%). In Groups A1 and A2, 50% of the first UTI were due to Candida ( 11/28) or E. coli (4/28), the remaining 50% were due to other Gram negatives and Staph. species. Mean gestational age (GA) in groups A1 and A2 were similar (29 ± 2 and 29 ± 4 weeks); GA was 39 weeks for all 3 infants in Group B. However, mean GA of infants with Candida UTI was 27 ± 2 weeks, and for bacterial UTI 30 ± 3 weeks (p<.01). 1st 2nd 3rd Abnormal Predominant DOL UTI UTI UTI U/S VCUG Organism Rx (days) Circumcision Group A1 38 0 0 4/17 2/21 Candida, 14 67 (n=19) E. Coli Group A2 40 63 99 3/9 1/7 Candida, 18 111 (n=9) E. coli Group B 85 0 0 1/3 1/2 Candida, 11 99 (n=3) Enterococcus CONCLUSIONS: Premature uncircumcised males have an increased risk for UTI (Odds Ratio=8.2, 95% Cl, 2.3-22.9, p<.001). Circumcision appears beneficial in reducing the risk for recurrent UTI in these same infants.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
Volume47
Issue number2
StatePublished - Jan 1 1999

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Candida
Urinary Tract Infections
Escherichia coli
Intensive care units
Gestational Age
varespladib methyl
Microorganisms
Neonatal Intensive Care Units
Imaging techniques
Recurrence
Aftercare
Enterococcus
Birth Weight
Hospitalization

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

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Frequency and prevention of recurrent Urinary Tract Infections (UTI) in hospitalized infants. / Cason, D. L.; Carter, B. S.; Bhatia, Jatinder J.

In: Journal of Investigative Medicine, Vol. 47, No. 2, 01.01.1999.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: We investigated the frequency and prevention of recurrent UTI in infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU). METHODS: A retrospective review of all male infants admitted to the NICU from June 1996-September 1998 revealed 31/595 males with UTI. Infants were divided into 3 Groups: A1 < 37 weeks with 1 UTI, A2 < 37 weeks with >1 UTI, and B ≥37 weeks with any UTI. Gestational age, birth weight, age at diagnosis of UTI, microorganisms, follow-up care (including imaging studies) and recurrence rates prior to discharge were determined. The effect of circumcision on recurrence of UTI was also investigated. RESULTS: Thirty-one infants had 44 UTIs during the study period (5.2{\%}). In Groups A1 and A2, 50{\%} of the first UTI were due to Candida ( 11/28) or E. coli (4/28), the remaining 50{\%} were due to other Gram negatives and Staph. species. Mean gestational age (GA) in groups A1 and A2 were similar (29 ± 2 and 29 ± 4 weeks); GA was 39 weeks for all 3 infants in Group B. However, mean GA of infants with Candida UTI was 27 ± 2 weeks, and for bacterial UTI 30 ± 3 weeks (p<.01). 1st 2nd 3rd Abnormal Predominant DOL UTI UTI UTI U/S VCUG Organism Rx (days) Circumcision Group A1 38 0 0 4/17 2/21 Candida, 14 67 (n=19) E. Coli Group A2 40 63 99 3/9 1/7 Candida, 18 111 (n=9) E. coli Group B 85 0 0 1/3 1/2 Candida, 11 99 (n=3) Enterococcus CONCLUSIONS: Premature uncircumcised males have an increased risk for UTI (Odds Ratio=8.2, 95{\%} Cl, 2.3-22.9, p<.001). Circumcision appears beneficial in reducing the risk for recurrent UTI in these same infants.",
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N2 - OBJECTIVE: We investigated the frequency and prevention of recurrent UTI in infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU). METHODS: A retrospective review of all male infants admitted to the NICU from June 1996-September 1998 revealed 31/595 males with UTI. Infants were divided into 3 Groups: A1 < 37 weeks with 1 UTI, A2 < 37 weeks with >1 UTI, and B ≥37 weeks with any UTI. Gestational age, birth weight, age at diagnosis of UTI, microorganisms, follow-up care (including imaging studies) and recurrence rates prior to discharge were determined. The effect of circumcision on recurrence of UTI was also investigated. RESULTS: Thirty-one infants had 44 UTIs during the study period (5.2%). In Groups A1 and A2, 50% of the first UTI were due to Candida ( 11/28) or E. coli (4/28), the remaining 50% were due to other Gram negatives and Staph. species. Mean gestational age (GA) in groups A1 and A2 were similar (29 ± 2 and 29 ± 4 weeks); GA was 39 weeks for all 3 infants in Group B. However, mean GA of infants with Candida UTI was 27 ± 2 weeks, and for bacterial UTI 30 ± 3 weeks (p<.01). 1st 2nd 3rd Abnormal Predominant DOL UTI UTI UTI U/S VCUG Organism Rx (days) Circumcision Group A1 38 0 0 4/17 2/21 Candida, 14 67 (n=19) E. Coli Group A2 40 63 99 3/9 1/7 Candida, 18 111 (n=9) E. coli Group B 85 0 0 1/3 1/2 Candida, 11 99 (n=3) Enterococcus CONCLUSIONS: Premature uncircumcised males have an increased risk for UTI (Odds Ratio=8.2, 95% Cl, 2.3-22.9, p<.001). Circumcision appears beneficial in reducing the risk for recurrent UTI in these same infants.

AB - OBJECTIVE: We investigated the frequency and prevention of recurrent UTI in infants requiring prolonged hospitalization in the neonatal intensive care unit (NICU). METHODS: A retrospective review of all male infants admitted to the NICU from June 1996-September 1998 revealed 31/595 males with UTI. Infants were divided into 3 Groups: A1 < 37 weeks with 1 UTI, A2 < 37 weeks with >1 UTI, and B ≥37 weeks with any UTI. Gestational age, birth weight, age at diagnosis of UTI, microorganisms, follow-up care (including imaging studies) and recurrence rates prior to discharge were determined. The effect of circumcision on recurrence of UTI was also investigated. RESULTS: Thirty-one infants had 44 UTIs during the study period (5.2%). In Groups A1 and A2, 50% of the first UTI were due to Candida ( 11/28) or E. coli (4/28), the remaining 50% were due to other Gram negatives and Staph. species. Mean gestational age (GA) in groups A1 and A2 were similar (29 ± 2 and 29 ± 4 weeks); GA was 39 weeks for all 3 infants in Group B. However, mean GA of infants with Candida UTI was 27 ± 2 weeks, and for bacterial UTI 30 ± 3 weeks (p<.01). 1st 2nd 3rd Abnormal Predominant DOL UTI UTI UTI U/S VCUG Organism Rx (days) Circumcision Group A1 38 0 0 4/17 2/21 Candida, 14 67 (n=19) E. Coli Group A2 40 63 99 3/9 1/7 Candida, 18 111 (n=9) E. coli Group B 85 0 0 1/3 1/2 Candida, 11 99 (n=3) Enterococcus CONCLUSIONS: Premature uncircumcised males have an increased risk for UTI (Odds Ratio=8.2, 95% Cl, 2.3-22.9, p<.001). Circumcision appears beneficial in reducing the risk for recurrent UTI in these same infants.

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