Abstract

Urinary infections are an important cause of prolonged jaundice. But there is conflict about the role of the urinary infections on the pathological jaundice in the first 14 days of the life. This study aims to determine the frequency of urinary tract infections in neonates presenting with jaundice in the first 2weeks of life with bilirubin levels that require phototherapy.

This study was done with neonates 2–14 days old they have indirect bilirubin levels above the phototherapy limit but were not found to have any condition that would lead to elevated bilirubin levels, e.g. systemic infection, isoimmunization, erythrocyte enzyme defect, erythrocyte structural defect, hypothyroidism, sequestrated blood, polycythemia, or metabolic disease. Urine samples for urinalysis and culture were obtained using catheterization.

During the study, 482 neonates presented with jaundice and 262 of these fulfilled our criteria. UTI rate was 12%. Mean bilirubin level was 20.9+6.1mg/dl. Thirtyfive(13%) of these patients underwent to blood exchange, the rest were treated with phototherapy only. Weight loss in terms of percentage of birth weight was higher on uninfected patients and rebound bilirubin levels was higher on UTI group.

UTIs may present with isolated jaundice and may cause urosepsis, renal scarring, hypertension and chronic renal failure if they are not treated. In the neonatal period, infections lead to hyperbilirubinemia via hemolysis, inadequate conjugation, decreased excretion and oxidant stres. The findings of this study show the benefits of obtaining urine cultures for the diagnosis of UTI in neonatal patients with hyperibilirubinemia requiring phototherapy who have unexplained hyperbilirubinemia.