A Study of the Relation between Inflammatory Indicators and Urinary Tract Infection in Neonates

Abstract

Background & Aim: The research aims to study the influence of inflammatory indicators in newborns urinary tract infection (UTI), their sensitivity and specificity in diagnosis.

Materials and Methods: Cross-Sectional Study of a case-control type, conducted on newborns aged<28 days who were admitted to the Newborn and Premature Division of the University Children's Hospital in Damascus between 1/1/2019 to 1/1/2020. The cases group included 200 newborns with UTI (mean age 14.5 days, 70% males), and the control group included 200 newborns without UTI (mean age 14.7 days, 54% males), where 150 had infection other than UTI and 50 newborns without infection.

Results: We found that each of maternal UTI during childbirth, male gender, and urinary malformations are risk factors for newborns urinary tract infection. The prevalence of urinary symptoms is smaller than the prevalence of general. The pathogen was not detected in 25%, while Gram-negative bacteria were the most common pathogens (Escherichia coli 34.5%, Klebsiella 20%). Compared with the control group, we found that the CRP and ESR values have limited benefit in predicting newborns UTI, as the CRP values between 4.9-15 mg/L have a sensitivity 60.5%, specificity of 77%, a positive likelihood ratio (+LR) 2.6 and accuracy 68.8%, the ESR values between 9.7-17.86 mm/ hr have a sensitivity 57%, specificity 85%, +LR 3.8 and accuracy of 71%, and when both are achieved, the sensitivity becomes 49%, the specificity 92.5%, +LR is 6.5 and the accuracy 70.8%.

Conclusions: Maternal urinary tract infection during childbirth, male gender, and urinary abnormalities are risk factors for newborn urinary tract infection. Urinary symptoms are less common, while general symptoms are more frequent. WBC, CRP, and ESR values have limited benefit in diagnosing newborns urinary infection.