Do Systemic Inflammatory Indices, Urinalysis, and Radiological Findings Vary by Causative Pathogen in Neonatal Urinary Tract Infections?

Abstract

Objectives: Urinary tract infections (UTI) are the most common occult infections in infants under three months of age with high fever, caused by various pathogens, and can progress with different symptoms from mild to severe. We planned to explore and compare pathogen-specific systemic inflammatory indices, urinalysis, and radiological findings in newborns.

Methods: The retrospective study included preterm and term neonates with single pathogen growth of≥50.000 colony-forming units (CFU) /mL from urine cultures obtained by first-time catheterization between September 2019 and November 2021. Baseline hemogram parameters, acute phase reactants, systemic inflammatory indexes, urinalysis, and radiological findings were analyzed in pathogen-specific groups.

Results: Of the 132 patients included in the study, gastrointestinal symptoms were the most common. C-reactive protein values were higher in the non- E. Coli group (p<0.05). Procalcitonin values were higher in patients with Klebsiella spp. isolates (p<0.05). Systemic inflammatory indexes were higher in patients with Coagulase-Negative Staphylococci isolates (p<0.05). Urinary acidity was higher in the non-E. Coli group (p<0.05). Escherichia Coli and Klebsiella Spp. were isolated in two-thirds of patients with leukocyte esterase positivity. The most common cause of UTI in patients with abnormal renal ultrasound findings was E. Coli (33.3%).

Conclusion: Our findings imply that unconventional tests could assist in pathogen differentiation, determining clinical presentation, and prognosis.