Hyperbilirubinemia with Urinary Tract Infection in Infants Younger Than six Weeks OldA Hospital based study

Dr Dillip Kumar Dash; Dr M.D Mohanty; Dr Naresh Chandra achary

Volume : V, Issue : VII, July - 2016

Hyperbilirubinemia with Urinary Tract Infection in Infants Younger Than six Weeks OldA Hospital based study

Dr Dillip Kumar Dash, Dr M. D Mohanty, Dr Naresh Chandra Achary

Abstract :

Background: Neonatal Hyperbilirubinemia is one of the leading causes for hospital admission in newborn period. Previous studies have found that jaundice may be one of the initial symptoms related to urinary tract infection (UTI) in infants. There have been some reports regarding the relationship of idiopathic hyperbilirubinemia and bacterial infections,(3,5) such as urinary tract infection (UTI)(23).This study is intended particularly to evaluate the incidence and related factors of neonatal infants with the initial presentation of hyperbilirubinemia and final diagnosis of UTI in a tertiary teaching hospital. Aim: Is to assess the presence of urinary tract infection in new–born�s with unexplained ,hyperbilirubinemia in the first six weeks of life. Methods: We evaluate retrospectively the admitted infants younger than six weeks old with hyperbilirubinemia at our hospital for evaluation & treatment of jaundice between June 2015 and May 2016 for a span of one year. The jaundiced infants having tests of urinalysis were enrolled into our study and grouped into UTI or no UTI group according to the findings of urinary culture. With retrospective review of the whole year�s admission for hyperbilirubinemia in infants, the goal of the study was to evaluate the incidence and related factors in infants younger than 6 weeks old and having the initial presentation of hyperbilirubinemia and final diagnosis of UTI in a tertiary teaching hospital at eastern part odisha , India. Results: A total of 100 neonatal jaundiced infants were enrolled. Among them, 24 cases (24%) were grouped into the UTI group, and the most common cultured bacterium from their urine was Escherichia coli (37.5%). There was no significant difference in the babies� birth weight, gestational age, modes of delivery, gender and total bilirubin levels between the two groups. There was also no significant difference between the two groups in their admission age by days in UTI and no UTI groups, respectively).The ratio of outpatients (34.78% vs. 65.21% in UTI and no UTI groups, respectively) . The cases of UTI group had significantly lower hemoglobin12.22�2.3g/dL vs. 15.1� 2.8 g/dL, respectively) and higher formula feeding rate than the no UTI group (50% vs. 19.44%, respectively ( p < 0.05).Male gender baby are more commonly affected than female 31.03% VS 14.28% respectively. Presence of Maternal risk factor increases the occurrence of UTI i.e. sixteen out of twenty four cases are associated with maternal risk factor. Conclusion: The incidence of UTI in the admitted infants with hyperbilirubinemia was as high as approximately 24%. The most common cultured bacterium in urine was E coli. Therefore, performing urinary tests to exclude the possibility of coincidental UTI may be necessary for admitted jaundiced infants younger than 6weeks old to attain a faster recovery of the diseases and avoid morbidity and mortality