Korean Journal of Nephrology 1988;7(1):61-67.

신생아 요로감염증에 대한 임상적 관찰

김도현 , 이우길

Abstract

Urinary tract infection (UTI) in neonates is quite different from that in older infants and children such as route of infection, sex incidence, clinical manifestations and prognosis. It is a well known fact that they may present as life threatening episodes with serious progno- sis and may be the forerunners of severe renal disease as they grow-up. It is, however, difficult to diagnose UTI in neonates not only because their symptoms and signs are vague but also there are some difficulties in collecting the clean urine specimen. We observed the sex incidence, clinical features, caus- ative organisms, and laboratory and radiologic findings in 58 neonates with symptoms suggestive of UTI, who admitted to the Department of Pediatrics Hanyang University Hospital from July 1982 to June 1987. The results obtained were as follows; 1) UTI commonly presented in the first 2 weeks of age and boys were affected more frequently than girls (M:F=2:1). 2) Chief complaints on admission were fever, jaun- dice, irritability, diarrhea and so on. 3) Major causative organisms were E. coli, Enterococ- ci, Staphylococcus aureus and Klebsiella. 4) Positive blood cultures were obtained from 13 cases among 56 cases, but only 1 case contained a pathogen identical with that isolated from the urine (E. coli). Positive umbilical cultures were found in 34 cases among 52 cases. Most of them had multiple bacterial growths. In 10 cases same organisms grew on simultane- ously urine and umbilical cultures and none of cases from urine, blood, and umbilical cultures. The route of infection was still uncertain. 5) Wide variations in laboratory features of WBC count in CBC, urinalysis, CRP, ESR and renal function tests were noted 6) We could not obtain the significance of radiologic investigations in neonates with UTI because of not performed the radiologic examination in adequate fig- ures of patients. 7) All neonates responded promptly to antimicrobial therapy. The mean duration of febrile state and hospi- talization were 2.1±1.2 days and 9.7±4.2 days respec- tively. 8) It was not possible to get enough information about antenatal and birth histories, so we could not observe the consequence of maternal infections to neon- ates.