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Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection

Journal of Perinatology volume 35, pages 362–366 (2015)Cite this article

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Abstract

Objective:

The 2011 American Academy of Pediatrics (AAP) guidelines address imaging after initial febrile urinary tract infection (UTI) in infants >2 months of age. We sought to determine the frequency of upper urinary tract anomalies (hydronephrosis and vesicoureteral reflux (VUR)) in hospitalized premature infants with UTI.

Study design:

We retrospectively reviewed the electronic medical records of neonatal intensive care unit (NICU) admissions at a tertiary care children’s hospital between 1 January 2006 and 31 December 2010. We queried the records for UTI, renal ultrasound (US) and voiding cystourethrogram (VCUG).

Result:

We identified 3518 unique admissions. UTI occurred in 118 infants (3%). Sixty-nine (60%) had a normal US. Renal dilation was predominantly renal pelvic dilation (12%) and isolated caliectasis (22%). VUR was identified in 15 (14%) infants evaluated with a VCUG. VUR was identified in nine (12%) infants without and in seven (16%) with an abnormality on US. Reflux was identified in 7% of male and 38% of female infants with a UTI.

Conclusion:

Anatomic abnormalities of the upper urinary tract are uncommon in premature infants with a UTI that occurs during neonatal hospitalization. In concordance with the AAP guidelines, a VCUG may not be required in all NICU infants under age 2 months after a single UTI.

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Authors and Affiliations

  1. Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine and St Louis Children’s Hospital, Saint Louis, MO, USA,

    A Vachharajani & T Najaf

  2. Division of Urology, Department of Surgery, Washington University School of Medicine and St Louis Children’s Hospital, Saint Louis, MO, USA,

    G J Vricella & D E Coplen

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  1. A Vachharajani
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  2. G J Vricella
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  3. T Najaf
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  4. D E Coplen
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Correspondence to D E Coplen.

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The authors declare no conflict of interest.

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Vachharajani, A., Vricella, G., Najaf, T. et al. Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection. J Perinatol 35, 362–366 (2015). https://doi.org/10.1038/jp.2014.209

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