Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital

  • Novie Amelia
  • Idham Amir
  • Partini P Trihono
Keywords: urinary tract infection, late-onset sepsis, neonate

Abstract

Background Urine culture, as part of a full septic work-up for
late-onset neonatal sepsis, was not routinely done in the Neona-
tal Ward at Cipto Mangunkusumo Hospital, and as of today, the
prevalence of urinary tract infection (UTI) among neonates with
late-onset sepsis remains unknown.
Objectives To determine the prevalence and microbiological pat-
terns of UTI among late-onset neonatal sepsis in Cipto
Mangunkusumo Hospital.
Methods We conducted a cross-sectional study on all neonates
diagnosed as suspected late-onset sepsis who underwent sep-
sis evaluation between 20 October 2003 – 30 April 2004. Urine
specimens were collected by bladder catheterization for culture
and urinalysis.
Results UTI was found in 14.9% (7/47) neonates who under-
went urine culture (male: female ratio was 5:2). Six subjects
who had UTI were preterm neonates, Klebsiella pneumoniae
was found in both blood and urine cultures of 1 subject, while the
others showed different microorganisms. Forty-five out of 47
subjects, who were suspected of late-onset sepsis, had posi-
tive blood cultures. All subjects with UTI had positive bacteriuria
from Gram-stained specimen.
Conclusions The prevalence of UTI among neonates with late-
onset sepsis in Cipto Mangunkusumo Hospital was 14.9%. The
microorganisms most frequently found in urine cultures were
Pseudomonas sp., Staphylococcus epidermidis, and Klebsiella
pneumoniae. Urine culture, urinalysis, and urinary Gram-stain
should be performed as part of sepsis evaluation for late-onset
neonatal sepsis, especially in male and preterm neonates

Author Biographies

Novie Amelia
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Idham Amir
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Partini P Trihono
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

References

1. Klein JO. Bacterial infections of the urinary tract. In:
Remington JS, Klein JO, editors. Infectious disease of the
fetus and newborn infant. 5th ed. Philadelphia: WB
Saunders; 2001. p. 1035-46.
2. Gonzalez R. Urinary tract infection. In: Behrman RE,
Kliegman RM, Jenson HB, editors. Nelson’s textbook of
pediatrics. 17th ed. Philadelphia: Saunders; 2004. p. 549.
3. Jones KV, Asscher AW. Urinary tract infection and
vesicoureteral reflux. In: Edelmann Jr CM, editor. Pedi-
atric Kidney Disease. 2nd ed. Boston: Little, Brown and
Co; 2000. p. 1926-78.
4. Visser VE, Hall RT. Urine culture in the evaluation of
suspected neonatal sepsis. J Pediatr 1979;94:635-8.
5. DiGeronimo RJ. Lack of efficacy of the urine culture as
part of the initial work-up of suspected neonatal sepsis.
Pediatr Infect Dis J 1992;9:764-6.
6. Purniti P S. Uji diagnostik beberapa parameter klinis
untuk diagnosis ISK pada sepsis neonatorum [thesis].
Denpasar (Bali, Indonesia): Medical School, Udayana
Univ.; 2002.
7. Tamim MM, Alesseh H, Aziz H. Analysis of the efficacy
of urine culture as part of sepsis evaluation in the prema-
ture infant. Pediatr Infect Dis J 2003;22:805-8.
8. Bauer S, Eliakim A, Pomeranz A, Regev R, Litmanovitz I,
Arnon S, et al. Urinary tract infection in very low birth
weight preterm infants. Pediatr Infect Dis J 2003;22:426-9.
9. Shaw KN, Gorelick MH. Urinary tract infection in the
pediatric patient. Pediatr Clin N Am 1999;46:1111-24.
10. Klein JO, Marcy M. Bacterial sepsis and meningitis. In:
Remington JS, Klein JO, editors. Infectious disease of the
fetus and newborn infant. 5th ed. Philadelphia: WB
Saunder; 2001. p. 943-98.
11. To T, Agha M, Dick PT. Cohort study on circumcision of
newborn boys and subsequent risk of urinary tract infec-
tion. Lancet 1998;352:1813-16.
12. Schoen EJ, Colby CJ, Ray GT. Newborn circumcision
decreases incidence and costs of urinary tract infections
during the first year of life. Pediatrics 2000;105:789-93.
13. Wiswell TE. The prepuce, urinary tract infections, and
the consequences. Pediatrics 2000;105:860-1.
14. Wiswell TE, Miller GM, Gelston HM. The effect of cir-
cumcision status on periurethral bacterial flora during
the first year of life. J Pediatr 1988;113:442-6.
15. Abbott GD. Neonatal bacteriuria: A prospective study of
1460 infants. BMJ 1972;1;267-9.
16. Littlewood JM, Kite P, Kite BA. Incidence of neonatal
urinary tract infection. Arch Dis Child 1969;44:617-9.
17. Lohr JA, Donowitz LG, Sadler JE 3rd. Hospital acquired
urinary tract infection. Pediatrics 1989;83:193-6.
18. Davies HD, Jones ELF, Sheng RY. Nosocomial urinary
tract infections at a pediatric hospital. Pediatr Infect Dis
J 1992;11:349-51.
19. Falcao MC, Leone CR, D’Andrea RA, Berardi R, Ono
NA, Vaz VAC. Urinary tract infection in full-term new-
born infants: Risk factor analysis. Rev Hosp Clin Fac Med
S Paulo 2000;55:9-16.
20. Guida JD, Kunig AM, Leef KH, McKenzie SE, Paul DA.
Platelet count and sepsis in very low birth weight neo-
nates: Is there an organism-specific response? Pediatrics
2003;111:1411-15.
21. McDonald LC, Walker M, Carson L. Outbreak of
Acinetobacter spp: Bloodstream infections in a nursery
associated with contaminated aerosols and air condition-
ers. Pediatr Infect Dis J 1998;17:716-22.
22. Ariffin H, Navaratnam P, Kee TK, Balan G. Antibiotic
resistance patterns in nosocomial Gram-negative bacte-
rial infections in units with heavy antibiotic usage. J Trop
Pediatr 2004;50:26-31.
23. American Academy of Pediatrics. Practice parameter:
The diagnosis, treatment and evaluation of the initial
urinary tract infection in febrile infants and young chil-
dren. Pediatrics 1999;103:1-12.
24. Bachur R, Harper MB. Reliability of the urinalysis for
predicting urinary tract infections in young febrile chil-
dren. Arch Pediatr Adolesc Med 2001;155:60-5.
25. Lockhart GR, Lewander WJ, Cimini DM, Josephson SL,
Linakis JG. Use of urinary Gram stain for detection of
urinary tract infection in infants. Ann Emerg Med
1995;25:31-5.
26. Lohr JA, Portilla MG, Geuder TG, Dunn ML, Dudley
SM. Making a presumptive diagnosis of urinary tract in-
fection by using a urinalysis performed in an on-site labo-
ratory. J Pediatr 1993;122:22-5.
27. Weinberg AG, Gan VN. Urine screen for bacteriuria in
symptomatic pediatric outpatients. Pediatr Infect Dis J
1991;10:651-4.
Published
2016-10-13
How to Cite
1.
Amelia N, Amir I, Trihono P. Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital. PI [Internet]. 13Oct.2016 [cited 20Jan.2022];45(5):217-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/843
Received 2016-10-10
Accepted 2016-10-10
Published 2016-10-13