Urinary tract infection caused by Enterobacteriaceae and its relationship with vesicoureteral reflux

Background

The first urinary tract infection can be a marker of a urinary tract anomaly, mainly vesicoureteral reflux. The aim of this work was to determine the association between isolated Enterobacteriaceae with the presence and grade of vesicoureteral reflux in neonatal patients at their first urinary tract infection.

Methods

A retrospective, observational and analytic study of newborns, who were admitted to the Neonatal Department, of the University Pediatric Hospital Juan Manuel Márquez, in Havana, Cuba, from 1992 to 2013, was conducted. The causal microorganism of urinary tract infection was from the Enterobacteriaceae family. They were evaluated by radio imaging. The association between the presence and grade of vesicoureteral reflux with the causal microorganism of the urinary tract infection was analyzed.

Results

Newborn infants with urinary tract infection (450) were studied. Bacterial isolations in the urine cultures corresponded to E. coli in 316 cases (70.2%). The prevalence of vesicoureteral reflux was 18.2%. The presence of bacteria corresponding to the Enterobacteriaceae family (other than E. coli) had a significant risk association with vesicoureteral reflux (OR: 2.02; p < 0.01) and vesicoureteral reflux classification (for higher grades, p < 0.01).

Conclusions

E. coli is the most common causal microorganism in neonatal urinary tract infection. However, an association between the isolation of a microorganism of the Enterobacteriaceae family different to E. coli with the presence of vesicoureteral reflux and mainly with higher grades of vesicoureteral reflux exists.