Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital
Keywords:
urinary tract infection, late-onset sepsis, neonate
Abstract
Background Urine culture, as part of a full septic work-up forlate-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
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fetus and newborn infant. 5th ed. Philadelphia: WB
Saunders; 2001. p. 1035-46.
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pediatrics. 17th ed. Philadelphia: Saunders; 2004. p. 549.
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vesicoureteral reflux. In: Edelmann Jr CM, editor. Pedi-
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4. Visser VE, Hall RT. Urine culture in the evaluation of
suspected neonatal sepsis. J Pediatr 1979;94:635-8.
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part of the initial work-up of suspected neonatal sepsis.
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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.
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1460 infants. BMJ 1972;1;267-9.
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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.
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 20Apr.2024];45(5):217-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/843
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Received 2016-10-10
Accepted 2016-10-10
Published 2016-10-13
Accepted 2016-10-10
Published 2016-10-13
