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Urinary tract infections in very premature neonates: the definition dilemma

Journal of Perinatology (2024)Cite this article

Subjects

Abstract

Background and objectives

Data on urinary tract infections (UTIs) in very preterm neonates (VPTNs) are scarce. We aimed to (i) describe the characteristics of UTIs in VPTNs and (ii) compare the diagnostic practices of neonatal clinicians to established pediatric guidelines.

Methods

All VPTNs (<29 weeks GA) with a suspected UTI at the CHU Sainte-Justine neonatal intensive care unit from January 1, 2014, and December 31, 2019, were included and divided into two definition categories: Possible UTI, and Definite UTI.

Results

Most episodes were Possible UTI (87%). Symptoms of UTIs and pathogens varied based on the definition category. A positive urinalysis was obtained in 25%. Possible UTI episodes grew 2 organisms in 62% of cases and <50,000 CFU/mL in 62% of cases.

Conclusion

Characteristics of UTIs in VPTNs vary based on the definition category and case definitions used by clinicians differ from that of established pediatric guidelines.

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Fig. 1: Study Flow Chart: Deriving first episodes of microbial growth in very preterm newborns (VPTNs) from the CNN and microbiology laboratory database.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available to preserve the privacy of patient data but are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Assil Abda, Christian Lachance & Melanie Sicard

  2. Department of Pediatrics, Division of Infectious Diseases, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Luc Panetta, Julie Blackburn & Philippe Ovetchkine

  3. Pediatric Emergency Department, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Lyon, France

    Luc Panetta

  4. Research center, CHU Sainte-Justine, Montreal, QC, Canada

    Julie Blackburn, Christian Lachance, Philippe Ovetchkine & Melanie Sicard

  5. Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, QC, Canada

    Julie Blackburn & Melanie Sicard

  6. Department of Pediatrics, Division of General Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Isabelle Chevalier

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Contributions

Drs Assil Abda, Julie Blackburn, Christian Lachance, Luc Panetta, and Melanie Sicard contributed to the study design. Dr. Assil Abda designed the data collection instruments, collected data, carried out analyses, drafted the initial manuscript, and critically reviewed and revised the manuscript. Dr. Luc Panetta collected data and critically reviewed and revised the manuscript. Dr. Melanie Sicard conducted analyses, created the initial data tables, and critically reviewed and revised the manuscript. Drs Philippe Ovetchkine, Julie Blackburn, and Isabelle Chevalier critically reviewed and revised the manuscript. Dr. Christian Lachance conceptualized the study, supervised data collection, and critically reviewed and revised the manuscript. All authors approved the final manuscript and agreed to be accountable for all aspects of the work.

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Correspondence to Assil Abda.

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Supplementary information

41372_2024_1951_MOESM1_ESM.docx

Supplementary Table 1. Microbiologic characteristics of the four episodes with concomitant bacteremia with the same pathogen

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Abda, A., Panetta, L., Blackburn, J. et al. Urinary tract infections in very premature neonates: the definition dilemma. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01951-1

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