Study of Urinary Tract Infection and Bacteriuria in Neonatal Sepsis

Objective: To determine magnitude of Urinary tract infection (UTI) in neonatal sepsis and to evaluate bacteriuria as indicator of neonatal urinary tract infection for use in resource limited settings.

Methods: This prospective study of 200 neonates was conducted in NICU of MVJ Medical College and Research Hospital. Two hundred neonates were included in the study. There were 130 term (93 boys, 37 girls) and 70 pre-term neonates (47 boys, 23 girls). Early onset sepsis group comprised of 109 neonates and late onset sepsis group comprised of 91 neonates.

Results: The overall magnitude of UTI was 6%. The urine culture positivity in the early onset sepsis group was 1.83% and in the late onset group was 10.98% (p <0.05). Urine culture positivity in proven sepsis was 6.32% and in suspected sepsis group was 5.78%. The sensitivity of bacteriuria in neonatal UTI was 91.6% and specificity was 97.8%.

Conclusions: Magnitude of UTI in neonatal sepsis is 6%, with urine culture positivity in late onset sepsis being much higher than in early onset sepsis. Bacteriuria has good sensitivity and specificity in resource limited settings in detecting septic neonates with UTI.