Factors Associated with Urinary Tract Infection in Neonates with Prolonged Jaundice Admitted to Neonatal Intensive-Care Unit (NICU)

Document Type : Original Article (s)

Authors

1 Student, Department of Nursing , School of Nursing and Midwifery AND Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Assistant Professor, Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Student, Department of Midwifery, School of Nursing and Midwifery AND Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Student, Department of Nursing, School of Nursing and Midwifery AND Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

5 MSc Student, Department of Nursing, School of Nursing and Midwifery AND Students Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran

6 Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

Background: Jaundice is the most common disease in neonates; prolonged jaundice lasts for more than 14 days in neonates and more than 21 days in premature neonates. Urinary tract infection (UTI) is a potentially serious disease during infancy and childhood and with replication can cause many problems and irreversible effects. This study aimed to identify the factors affecting urinary tract infection in hospitalized neonates in neonatal intensive-care unit (NICU) with prolonged jaundice.Methods: In this cross-sectional study, from 1844 studied infants during 3 years of 2010-2013, 91 infants admitted to the NICUs of hospitals in Kermanshah city, Iran, due to prolonged jaundice, were enrolled. Via convince sampling, data were collected using a checklist including the demographic data, type of the delivery, type of neonate feeding, birth weight, gestational age, presence or absence of urinary tract infection and parents' kinship. Data were analyzed using descriptive and inferential statistics via SPSS software.Findings: The prevalence of urinary tract infection in neonates with prolonged jaundice was 59.3 percent. Gender, gestational age, type of delivery, and parents' kinship were not related to urinary tract infection. Feeding type and urinary tract infection were significantly related (P < 0.05).Conclusion: Feeding type has an impact on urinary tract infection and breastfeeding is a priority. In addition, urine culture in neonates with prolonged jaundice, or those with unknown cause, may be advantageous.

Keywords


  1. Garcia FJ, Nager AL. Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics 2002; 109(5): 846-51.
  2. Khalesi N, Sharaky T, Haghighe M. Prevalence of urinary tract infection in neonates with prolonged jaundice referred to Aliasghar Hospital in Zahedan (2005). Qom Univ Med Sci J 2007; 11(3): 14-8. [In Persian].
  3. Hajebrahim Tehrani F, Valaie N. Incidence of septicemia and urinary tract infection in newborns with jaundice hospitalized in Mofid hospital. Feyz 2004; 7(4): 58-63. [In Persian].
  4. Islami Z, Ghasemi A. A survey of the urinary tract infection in icteric neonates. Tehran Univ Med J 2009; 66(11): 843-7. [In Persian].
  5. Eghbalian F, Monsef AR. Prolonged jaundice as an early manifestation of asymptomatic urinary tract infection. Urmia Med J 2009; 20(2): 98-103. [In Persian].
  6. Huang MJ, Kua KE, Teng HC, Tang KS, Weng HW, Huang CS. Risk factors for severe hyperbilirubinemia in neonates. Pediatr Res 2004; 56(5): 682-9.
  7. Ratnavel N, Ives NK. Investigation of prolonged neonatal jaundice. Current Paediatrics 15(2): 85-91.
  8. Jahanshahifard S, Askari F. Comparative study of factors related to urinary tract infection in children. Urmia Med J 2010; 21(1): 37-41. [In Persian].
  9. Rostami N, Magsodian F, Arian Pour M, Arian MR. Prevalence of asymptomatic urinary tract Infection in primary school children of Ardabil. J Ardabil Univ Med Sci 2005; 5(3): 241-5. [In Persian].
  10. Sayedzadeh SA, Vazirian Sh, Yavari T, Karimi L, Soliemani A. Clinical and laboratory aspects of urinary tract infections in hospitalized children. Behbood J 2009; 13(3): 211-9. [In Persian].
  11. Yousefi P, Cyrus A, Moghaddasi Z, Dorreh F, Aravand A. The frequency of recurrence of urinary tract infection (UTI) in 1- month to 12-year-old children without congenital abnormalities referred to Arak Amir Kabir Hospital. J Zanjan Univ Med Sci 2011; 19(76): 66-76. [In Persian].
  12. American Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on Urinary Tract Infection. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics 1999; 103(4 Pt 1): 843-52.
  13. Ghaemi S, Fesharaki RJ, Kelishadi R. Late onset jaundice and urinary tract infection in neonates. Indian J Pediatr 2007; 74(2): 139-41.
  14. Chen HT, Jeng MJ, Soong WJ, Yang CF, Tsao PC, Lee YS, et al. Hyperbilirubinemia with urinary tract infection in infants younger than eight weeks old. J Chin Med Assoc 2011; 74(4): 159-63.
  15. Rashed YK, Khtaband AA, Alhalaby AM. Hyperbilirubinemia with urinary tract infection in infants younger than eight weeks old. J Pediatr Neonatal Care 2014; 1(6): 00036.
  16. Chowdhury T, Kisat H, Tullus K. Does UTI cause prolonged jaundice in otherwise well infants? Eur J Pediatr 2015; 174(7): 971-3.
  17. Cetinkaya M, Ozkan H, Koksal N. Prolonged neonatal hyperbilirubinemia and urinary tract infections. Early Human Development 2010; 86(Suppl): S72.
  18. Shahian M, Rashtian P, Kalani M. Unexplained neonatal jaundice as an early diagnostic sign of urinary tract infection. Int J Infect Dis 2012; 16(7): e487-e490.
  19. Maisels MJ, Kring E. Risk of sepsis in newborns with severe hyperbilirubinemia. Pediatrics 1992; 90(5): 741-3.
  20. Pashapour N, Nikibahksh AA, Golmohammadlou S. Urinary tract infection in term neonates with prolonged jaundice. Urol J 2007; 4(2): 91-4.
  21. Bilgen H, Ozek E, Unver T, Biyikli N, Alpay H, Cebeci D. Urinary tract infection and hyperbilirubinemia. Turk J Pediatr 2006; 48(1): 51-5.
  22. Levy I, Comarsca J, Davidovits M, Klinger G, Sirota L, Linder N. Urinary tract infection in preterm infants: the protective role of breastfeeding. Pediatr Nephrol 2009; 24(3): 527-31.
  23. Marild S, Hansson S, Jodal U, Oden A, Svedberg K. Protective effect of breastfeeding against urinary tract infection. Acta Paediatr 2004; 93(2): 164-8.
  24. Hematyar M, Emami P. Incidence of urinary tract infection in hospitalized icteric neonates in Javaheri hospital (2003-2006). J Med Counc I.R. Iran 2009; 27(3):343-8. [In Persian