Prevalence of urinary tract infection in 2-8-week-old infants with jaundice

  • Partini Trihono Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Arfianti Chandra Dewi Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Hartono Gunardi Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
  • Hanifah Oswari Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Keywords: jaundice, UTI, infants, hyperbilirubinemia


Background Urinary tract infections (UTI) in infants may manifest in various ways and often appear without symptoms. Previous studies have reported that j aundice has been observed in infants aged less than 8 weeks 'With UTIs. However, a prospective study on the prevalence of UTI in infants with jaundice aged 2ô€‚8
weeks is warranted in order to improve diagnosing capability and provide prompt treatment.

Objective To investigate the prevalence and profiles of UTI in infants with jaundice aged 2ô€‚8 weeks.

Methods This crossô€‚sectional study was carried out in June-December 2011 in infants with jaundice aged 2ô€‚8 weeks. Subjects were patients from the Department of Child Health, Cipto Mangunkusumo Hospital (CMS), as well as the Pediatric Polyclinics ofBudi Kemuliaan and Thamrin Hospitals. All subjects underwent total, direct and indirect bilirubin examinations, urinalyses and urine cultures.

Results Of the 110 subjects recruited, the prevalence of UTI was 18.2%. More boys than girls had UTIs (13 boys, 7 girls). The microorganisms found in subjects v.ith UTIs were Escherichia coli (10/20), Klebsiella pneumoniae (8/20), and Enterobacter aerogenes (2120). Indirect hyperbilirubinemia was found in 5/20 subjects. There were more subjects with UTIs in the nonô€‚exclusively breastfed (8/20) and nonô€‚breastfed (8/20) groups than in the exclusively breastfed group (4/20), the full term gestational age (GA) group (17/20) than the pretenn GA group (3/20), and the normal birth weight group (15/20) than the low birth weight group (5/20). The median age of jaundice onset was 3.5 days (range lAO days), and the median duration of jaundice was 13.5 days (range 3-56 days).

Conclusion The prevalence of UTI in infants aged 2ô€‚8 weeks v.ith jaundice was 18.2%. More boys than girls had UTIs. The most common infecting microorganism found in our subjects was Escherichia coli. In daily medical practice, infants with prolonged jaundice of more than 2 weeks should be tested byurin alysis and urine cultures for the presence of UTIs. [Paediatr Indones.



1. Qureshi AM. Clinical presentation of urinary tract infection among children at Ayub Teaching Hospital, Abbotabad. J Ayub Med Coli Abbottabad. 2005;17m,81.
2. Chang S. Pediatric urinary tract infections. Pediatr Clin N Am. 2006;53,379-400.
3. Barton M, Bell Y, T hame M, Nicholson A. Urinary tract infections admitted to the University Hospital of the West Indies. West Indian Med). 2008;2,101,5.
4. Satish M, Agarwal R, Deorari AK, Paul VK. Jaundice in newborns. Indian) Pediatr. 2008;75,157,63.
5. Garda FJ, Nager AL. Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics. 2002;109:846􀁌
6. Chen HT, )eng M), Soong W), Yang CF, Tsao PC, Lee YS, et al. Hyperbilirubinemia v.ith urinary tract infection in infants younger than eight weeks old. J Chin Med Assoc. 2011;74,159,63.
7. Omar C, Hamza S, Bassem A, Mariam R. Urinary tract infection and indirect hyperbilirubinemia in newborns. N Am) Med Sci. 2011;544,7.
8. Bernstein J, Bwwn A. Sepsis and jaundice in early infancy. Pediatrics. 1962;6,873 ,82.
9. N g SH, Rawstron JR. Urinary tract infections presenting with jaundice. Arch Dis Child. 1971;46,173,6.
10. Gorelick MH, Shaw KN. Screening tests for urinary tract infection in children: a meta􀁌analysis. Pediatrics. 1999; 104,e54.
11. Davies HD. Bag urine specimens still not appropriate in diagnosing urinary tract infections in infants. Paediatr Child Health. 2004;9,377-8.
12. Schroerder AR, Newman T, Wasserman RC, Finch SA, Pantell RH. Choice of urine collection methods for the diagnosis of urinary tract infection in young, febrile infants. Arch Pediatr Adolese Med. 2005;159,915-22.
13. Guideline for the evaluation of cholestatic jaundice in infants: recommendation of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2004;39,115-28.
14. Li PS, Wong SN. Is bag urine culture useful in monitoring urinary tract infection in infants? J Paediatr Child Health. 2002,38;377-81.
15. Ghaemi S, Fesharaki RJ, Kelishadi R. Late onset jaundice and urinary tract infection in neonates. Indian J Pediatr. 2007 ;74, 139-41.
16. Pashapour N, Nikibahksh A, Golmohammadlou S. Urinary tract infection in term neonates with prolonged jaundice. Ural j. 2007;4,91-4.
17. Rabet LM, Vos Ap, Boehm G, Garssen J. Breast feeding and its role in early development of the immune system in infants: consequences for health later in life. J Nutr. 2008; 138: 1782-90.
18. Jackson KM, Nazar AM. Breastfeeding, the immune response, and long􀁍tenn health. J Am Osteopath Assoc. 2009; 106:203-7.
19. Bilgen H, Q,ek E, Unver T, Biyikh N, Alpay H, Cebeci D. Urinary tract infection and hyperbilirubinemia. Turk J Pediatr. 2006;48,51-5.
20. Lee H, Fang S, Yeung C, Tsai J. Urinary tract infections in infants: comparison between those with conjugated vs unconjugated hyperbilirubinemia. Ann Trop Paediatr. 2005 ;25.277-82.
How to Cite
Trihono P, Dewi A, Gunardi H, Oswari H. Prevalence of urinary tract infection in 2-8-week-old infants with jaundice. PI [Internet]. 31Oct.2012 [cited 30Nov.2023];52(5):304-. Available from:
Received 2016-09-07
Accepted 2016-09-07
Published 2012-10-31