Retrospective evaluation of cases followed due to urinary tract infection in the neonatal intensive care unit

Introduction: Early diagnosis after the first symptomatic UTI, rapid and effective treatment, and detection of congenital urinary malformations, if any, are the most important steps in preventing acute and chronic complications. This study was conducted to retrospectively evaluate cases of UTI in neonates. Material and Method: The study was conducted by retrospectively examining the file data of 276 patients diagnosed with UTI who were hospitalized and followed up in the Neonatal Intensive Care Unit of KTU Farabi Hospital between 2012-2022. Results: Among newborns with UTI, jaundice emerged as the leading symptom (%41.7). Notably, Klebsiella pneumoniae (22.1%) and E. coli (19.9%) were the most prevelant bacterial isolates in urine cultures. Urosepsis was observed in %3.3 of the cases. Blood culture positivity rates were significantly higher in UTI patients with: gestational age <28 weeks, birth weight <1500 grams, underlying urinary malformation and fever symptoms (p<0.05). Urinary malformations were detected in 15.6% of the cases, while renal scars were present in 6.5%. Patients with positive blood cultures and urinary malformations had a significantly higher incidence of renal scarring, recurrent infections, and complications compared to those without (p<0.05). Conclusion: In neonates with symptoms suggestive of UTI, obtaining a urine culture along with a blood culture, administering parenteral treatment until the blood cultre results are available, and considering a uropathogen count of 10.000 CFU/mL in urine culture as a significant threshold for UTI diagnosis are crucial. Additionally, close monitoring of neonates with fever, positive blood cultures, or urinary malformations is essential due to their increased risk of renal scarring, which can help prevent UTI-related morbidity and mortality. Keywords: Newborn, urinary tract infection, urinary malformation, urosepsis