Document Detail

Jaundice as an early diagnostic sign of urinary tract infection in infancy.
MedLine Citation:
PMID:  11986445     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Urinary tract infections (UTIs) are a common clinical problem in febrile infants younger than 8 weeks old, with a prevalence between 5% and 11%. Previous studies have noted that jaundice may be one of the first signs of a bacterial infection in infants. Our goal was to determine the incidence of UTIs in asymptomatic, jaundiced infants younger than 8 weeks old and to determine which historical and laboratory parameters are associated with UTIs. METHODS: We prospectively evaluated asymptomatic, jaundiced infants younger than 8 weeks old for evidence of a UTI (defined as >10 000 colony-forming units per milliliter of a single pathogen, obtained by bladder catheterization). A serum fractionated bilirubin level was obtained on all study patients. Detailed questionnaires were completed, which included demographic information, prenatal, intrapartum, and postnatal events. RESULTS: Twelve (7.5%) of 160 infants had a UTI (95% confidence interval: 3.9%-12.7%). Isolated organisms included Escherichia coli, Enterobacter cloacae, Enterococcus, Klebsiella pneumoniae, group B Streptococcus, Streptococcus viridans, and Staphylococcus aureus. Patients with the onset of jaundice after 8 days of age had a higher incidence of UTI, 6 (50%) of 12 infants in the positive culture group, versus 15 (10%) of 148 infants in the negative culture group. Abnormal urinalysis and microscopy results were noted in 5 (42%) of 12 infants with a UTI, and 6 (55%) of 11 infants had abnormal renal ultrasound results. CONCLUSION: A UTI was found in 7.5% of asymptomatic, afebrile, jaundiced infants younger than 8 weeks old. In addition, infants with the onset of jaundice after 8 days of age or patients with an elevated conjugated bilirubin fraction were more likely to have a UTI. Therefore, we recommend that testing for a UTI be included as part of the evaluation in asymptomatic, jaundiced infants presenting to the emergency department.
Francisco J Garcia; Alan L Nager
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  109     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-02     Completed Date:  2002-05-22     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  846-51     Citation Subset:  AIM; IM    
Division of Emergency and Transport Medicine, Childrens Hospital Los Angeles, Los Angeles, California, USA.
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MeSH Terms
Age Factors
Bacterial Infections / diagnosis,  epidemiology
Bilirubin / blood
Hyperbilirubinemia / blood,  epidemiology
Infant, Newborn
Jaundice / blood,  diagnosis*,  epidemiology
Jaundice, Neonatal / blood,  epidemiology
Prospective Studies
Urinary Tract Infections / blood,  diagnosis*,  epidemiology
Grant Support
Reg. No./Substance:
Comment In:
Pediatrics. 2003 Nov;112(5):1213-4; author reply 1213-4   [PMID:  14595074 ]
Pediatrics. 2003 Nov;112(5):1212-3; author reply 1212-3   [PMID:  14595073 ]

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