Research Article
BibTex RIS Cite

YENİDOĞAN YOĞUN BAKIM ÜNİTESİNDE İDRAR YOLU ENFEKSİYONU TANISI İLE İZLENEN PRETERM BEBEKLERİN RETROSPEKTİF DEĞERLENDİRİLMESİ

Year 2020, Volume: 17 Issue: 2, 328 - 330, 25.06.2020
https://doi.org/10.38136/jgon.677916

Abstract

Amaç: Yenidoğan yoğun bakım ünitesinde izlenen çok düşük doğum ağırlıklı bebeklerde idrar yolu enfeksiyonu riski artmaktadır. Çalışmamızda, yenidoğan yoğun bakım ünitesinde takip edildiği dönemde idrar yolu enfeksiyonu tanısı alan preterm bebeklerin risk faktörlerini, klinik bulgularını, eşlik eden üriner anomali varlığını, en sık izole edilen patojeni vurgulamayı amaçladık.
Gereçler ve Yöntem: Ocak 2016 ve Aralık 2017 tarihleri arasında hastanemiz yenidoğan yoğun bakım ünitesinde izlenen ve idrar yolu enfeksiyonu (İYE) tanısı alan 27 hasta retrospektif olarak incelendi.
Bulgular: Çalışmaya alınan hastaların %52’si kız (n:14) , %48’i erkek idi (n:13). Ortalama gestasyon haftası 34 hafta; doğum ağırlığı ise 2330 gramdı. Hastaların tanı anındaki en sık semptomları sırasıyla beslenme intoleransı, ateş ve apne idi (sırasıyla, %41, %33, %22). İdrar örnekleri 26 hastada üretral kateterle, 1 hastada suprapubik aspirasyon ile alındı. Hastalarda ortalama postnatal 35. günde idrar yolu enfeksiyonu gelişti. En sık izole edilen etken patojen Klebsiella pneumonia (n:17, %63) iken; sıklık sırasına göre Escherichia coli, Enterobacter aerogenes, Entrerokok feacalis, Serratia fonticola diğer izole edilen mikroorganizmalar oldu. Eş zamanlı bakılan kan kültüründe üreme saptanmayan 21 (%78) hasta, izole İYE tanısı aldı. 2 hasta BOS kültüründe Klebsiella pneumonia üremesi olması nedeni ile menenjit tanısı aldı. Postnatal dönemde yapılan ultrasonografik değerlendirmede 2 hastada üriner patoloji saptandı. İzlemde hiçbir hastanın üriner enfeksiyonu tekrarlamadı.
Sonuç: Yenidoğan yoğun bakım ünitesinde izlenen preterm bebeklerde idrar yolu enfeksiyonu sık görülmektedir. Klinik semptom varlığında veya geç neonatal sepsis tanısı düşünüldüğünde idrar kültürü geciktirilmeden alınmalıdır

References

  • KAYNAKLAR 1. Bauer S, Eliakim A, Pomeranz A, Regev R, Litmanovits I, Arnon S, et al. Urinary tract infection in very low birth weight preterm infants. Pediatr Infect Dis J. 2003; 22:426–30.
  • 2. Eliakim A, Dolfin T, Korzets Z, Wolach B, Pomeranz A. Urinary tract infection in prematüre infants: the role of imaging studies and prophylactic therapy. J Perinatol. 1997; 17:305-8.
  • 3. Tamim MM, Alesseh H, Aziz H. Analysis of theefficacy of urine culture as part of sepsis evaluation in the prematüre infant. Pediatr Infect Dis J. 2003; 22:805-8.
  • 4. Levy I, Comarsca J, Davidovits M, Klinger G, Sirota L, Linder N. Urinary tract infection in preterm infants: the protective role of breastfeeding. Pediatr Nephrol. 2009; 24:527-31.
  • 5. Downey LC, Benjamin DK Jr, Clark RH, Watt KM, Hornik CP, Laughon MM, et al. Urinary tract infection concordance with positive blood and cerebrospinal fluid cultures in the neonatal intensive care unit. J Perinatol 2013; 33:302-6.
  • 6. Adams GR, Ball CS, Corwin RM, Fuquay D, Harley BM, Heimerl MJ, et al. Practice Parameter: The Diagnosis, Treatment, and Evaluation of the Initial Urinary Tract Infection in Febrile Infants and Young Children. Pediatrics 1999;103:843-52
  • 7. Roberts KB, Downs SM, Finnell SM, Hellerstein S, Shortliffe LD, Wald ER, et al. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128:595-610
  • 8. Ağras K. Diagnostic evaluation of infants with antenatal hydronephrosis. Turk J Urol 2011;37:47-53.
  • 9. Mohseny AB, van Velze V, Steggerda SJ, Smits-Wintjens VEHJ, Bekker V, Lopriore E. Late-onset sepsis due to urinary tract infection in very preterm neonates is not uncommon. Eur J Pediatr 2018; 177:33-8
  • 10. Downey LC, Benjamin DK Jr, Clark RH, Watt KM, Hornik CP, Laughon MM, et al. Urinary tract infection concordance with positive blood and cerebrospinal fluid cultures in the neonatal intensive care unit. J Perinatol. 2013; 33: 302-6
  • 11. Clarke D, Gowrishankar M, Etches P, Lee BE, Robinson JL. Management and outcome of positive urine cultures in a neonatal intensive care unit. J Infect Public Health. 2010 Dec;3:152-8
  • 12. Nowell L, Moran C, Smith PB, Seed P, Alexander BD, Cotten CM et al. Prevalence of renal anomalies after urinary tract infections in hospitalized infants less than 2 months of age. J Perinatol. 2010; 30:281-5.
  • 13. Vachharajani A, Vricella GJ, Najaf T, Coplen DE. Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection. J Perinatol. 2015;35:362-6
  • 14. Cleper R, Krause I, Eisenstein B, Davidovits M. Prevalence of vesico ureteral reflux in neonatal urinary tract infection. Clin Pediatr (Phila). 2004;43:619-25
  • 15. Jantunen Me, Siitonen A, Ala-Houhala M, Ashorn P, Föhr A, Koskımıes O, et al. Predictive factors associated with significant urinary tract abnormalities in infants with pyelonephritis. Pediatr Infect Dis J. 2001;20:597-601
  • 16. Khalesi N, Khosravi N, Jalali A, Amini L. Evaluation of maternal urinary tract infection as a potential risk factor for neonatal urinary tract infection. J Family Reprod Health. 2014;8:59-62
  • 17. Milas V, Puseljić S, Stimac M, Dobrić H, Lukić G. Urinary tract infection (UTI) in newborns: risk factors, identification and prevention of consequences. Coll Antropol. 2013;37:871-6
  • 18. Tamim MM, Alesseh H, Aziz H. Analysis of the efficacy of urine culture as part of sepsis evaluation in the prematüre infant. Pediatr Infect Dis J. 2003;22:805-8
  • 19. VisserVE, Hall RT. Urineculture in theevaluation of suspected neonatal sepsis. J Pediatr. 1979; 94:635-8
  • 20. Phillips JR, Karlowicz MG. Prevalence of Candida species in hospital-acquired urinary tract infections in a neonatal intensive care unit. Pediatr Infect Dis J. 1997; 16:190-4.
  • 21. Urinary tract infections in neonates. In: UpToDate. Avilable at: Oct 02, 2018 Available from: https://www.uptodate.com/contents/urinary-tract-infections-in-neonates
Year 2020, Volume: 17 Issue: 2, 328 - 330, 25.06.2020
https://doi.org/10.38136/jgon.677916

Abstract

References

  • KAYNAKLAR 1. Bauer S, Eliakim A, Pomeranz A, Regev R, Litmanovits I, Arnon S, et al. Urinary tract infection in very low birth weight preterm infants. Pediatr Infect Dis J. 2003; 22:426–30.
  • 2. Eliakim A, Dolfin T, Korzets Z, Wolach B, Pomeranz A. Urinary tract infection in prematüre infants: the role of imaging studies and prophylactic therapy. J Perinatol. 1997; 17:305-8.
  • 3. Tamim MM, Alesseh H, Aziz H. Analysis of theefficacy of urine culture as part of sepsis evaluation in the prematüre infant. Pediatr Infect Dis J. 2003; 22:805-8.
  • 4. Levy I, Comarsca J, Davidovits M, Klinger G, Sirota L, Linder N. Urinary tract infection in preterm infants: the protective role of breastfeeding. Pediatr Nephrol. 2009; 24:527-31.
  • 5. Downey LC, Benjamin DK Jr, Clark RH, Watt KM, Hornik CP, Laughon MM, et al. Urinary tract infection concordance with positive blood and cerebrospinal fluid cultures in the neonatal intensive care unit. J Perinatol 2013; 33:302-6.
  • 6. Adams GR, Ball CS, Corwin RM, Fuquay D, Harley BM, Heimerl MJ, et al. Practice Parameter: The Diagnosis, Treatment, and Evaluation of the Initial Urinary Tract Infection in Febrile Infants and Young Children. Pediatrics 1999;103:843-52
  • 7. Roberts KB, Downs SM, Finnell SM, Hellerstein S, Shortliffe LD, Wald ER, et al. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128:595-610
  • 8. Ağras K. Diagnostic evaluation of infants with antenatal hydronephrosis. Turk J Urol 2011;37:47-53.
  • 9. Mohseny AB, van Velze V, Steggerda SJ, Smits-Wintjens VEHJ, Bekker V, Lopriore E. Late-onset sepsis due to urinary tract infection in very preterm neonates is not uncommon. Eur J Pediatr 2018; 177:33-8
  • 10. Downey LC, Benjamin DK Jr, Clark RH, Watt KM, Hornik CP, Laughon MM, et al. Urinary tract infection concordance with positive blood and cerebrospinal fluid cultures in the neonatal intensive care unit. J Perinatol. 2013; 33: 302-6
  • 11. Clarke D, Gowrishankar M, Etches P, Lee BE, Robinson JL. Management and outcome of positive urine cultures in a neonatal intensive care unit. J Infect Public Health. 2010 Dec;3:152-8
  • 12. Nowell L, Moran C, Smith PB, Seed P, Alexander BD, Cotten CM et al. Prevalence of renal anomalies after urinary tract infections in hospitalized infants less than 2 months of age. J Perinatol. 2010; 30:281-5.
  • 13. Vachharajani A, Vricella GJ, Najaf T, Coplen DE. Prevalence of upper urinary tract anomalies in hospitalized premature infants with urinary tract infection. J Perinatol. 2015;35:362-6
  • 14. Cleper R, Krause I, Eisenstein B, Davidovits M. Prevalence of vesico ureteral reflux in neonatal urinary tract infection. Clin Pediatr (Phila). 2004;43:619-25
  • 15. Jantunen Me, Siitonen A, Ala-Houhala M, Ashorn P, Föhr A, Koskımıes O, et al. Predictive factors associated with significant urinary tract abnormalities in infants with pyelonephritis. Pediatr Infect Dis J. 2001;20:597-601
  • 16. Khalesi N, Khosravi N, Jalali A, Amini L. Evaluation of maternal urinary tract infection as a potential risk factor for neonatal urinary tract infection. J Family Reprod Health. 2014;8:59-62
  • 17. Milas V, Puseljić S, Stimac M, Dobrić H, Lukić G. Urinary tract infection (UTI) in newborns: risk factors, identification and prevention of consequences. Coll Antropol. 2013;37:871-6
  • 18. Tamim MM, Alesseh H, Aziz H. Analysis of the efficacy of urine culture as part of sepsis evaluation in the prematüre infant. Pediatr Infect Dis J. 2003;22:805-8
  • 19. VisserVE, Hall RT. Urineculture in theevaluation of suspected neonatal sepsis. J Pediatr. 1979; 94:635-8
  • 20. Phillips JR, Karlowicz MG. Prevalence of Candida species in hospital-acquired urinary tract infections in a neonatal intensive care unit. Pediatr Infect Dis J. 1997; 16:190-4.
  • 21. Urinary tract infections in neonates. In: UpToDate. Avilable at: Oct 02, 2018 Available from: https://www.uptodate.com/contents/urinary-tract-infections-in-neonates
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Paediatrics
Journal Section Research Articles
Authors

Esra Özmen This is me 0000-0002-3368-1514

Burak Ceran 0000-0001-5914-5325

Fatma Sarı 0000-0003-4643-7622

Handan Bezirganoğlu 0000-0002-5720-7104

Evrim Alyamac Dizdar 0000-0001-8956-0917

Cüneyt Tayman 0000-0002-9970-0714

Şerife Oğuz This is me 0000-0001-5822-1808

Publication Date June 25, 2020
Submission Date January 21, 2020
Acceptance Date February 18, 2020
Published in Issue Year 2020 Volume: 17 Issue: 2

Cite

Vancouver Özmen E, Ceran B, Sarı F, Bezirganoğlu H, Alyamac Dizdar E, Tayman C, Oğuz Ş. YENİDOĞAN YOĞUN BAKIM ÜNİTESİNDE İDRAR YOLU ENFEKSİYONU TANISI İLE İZLENEN PRETERM BEBEKLERİN RETROSPEKTİF DEĞERLENDİRİLMESİ. JGON. 2020;17(2):328-30.