 | ||
|
| |    Urinary Tract Infections In Newborns by Lynn Cates, M.D., F.A.A.P. reviewed by Laura Jana, M.D., F.A.A.P. Just like older children, your newborn can develop a urinary tract infection (UTI) either from bacteria that enter the bladder from the outside or from bacteria in the bloodstream. It appears that urinary tract infections in newborns are relatively more likely to start from the bloodstream than in older infants and children. In addition, since newborns aren't able to wall off infections as well as older children, an infection that started in the urinary tract may spread to other organs through the bloodstream. For these reasons, all UTIs in newborns are treated as potentially very serious bloodstream infections. The exact rate of urinary tract infections in newborns is not known, but studies have found that from about 1 in 1,000 to 1 in 100 full-term infants, and up to 1 in 10 premature infants, will have a urinary tract infection during the first month of life. Just as in older children, the vast majority of these infections are caused by normal intestinal bacteria such as Escherichia coli (E coli). More common in boys than girls In contrast to older children, boys are much more likely than girls to get urinary tract infections in the newborn period. Several factors appear to contribute to this phenomenon including: The fact that uncircumcised boys have high rates of urinary tract infections, boys have more congenital abnormalities of the urinary tracts than girls, and boys have more bloodstream infections. Signs and symptoms Urinary tract infections may be relatively silent at any age, but if your newborn develops a UTI, he will have virtually no specific signs or symptoms to point directly to the urinary tract as his problem. His symptoms may be very subtle, consisting only of some decreased appetite or activity level, failure to gain weight on schedule, vomiting, diarrhea, poor color (even bluish skin color or cyanosis), fussiness, lethargy, or jaundice. These symptoms may start gradually or come on suddenly. He may or may not have an increased temperature with a urinary tract infection, no matter how severe it is. Congenital abnormalities A few newborns have external abnormalities that point to potential urinary tract abnormalities. Some of the most common include a two-vessel umbilical cord (instead of three) which contains only one artery (normally there are two), extra nipples, low-set ears, and spina bifida (an abnormality of the formation of the vertebral bones in the spine). Diagnosis The only way to know if a newborn infant has a urinary tract infection is to have a urine culture done. The best way to ensure that the specimen is not contaminated is to collect it by inserting a needle through the lower abdomen directly into the bladder (suprapubic aspiration). Otherwise, it is difficult to adequately cleanse the genitalia of newborns to get an accurate diagnosis. Since newborn infants are not able to wall off infections as well as older children and adults, whenever they show signs of most kinds of infections, they need to be carefully evaluated for possible spread of infection, especially to the bloodstream (sepsis) and to the brain (meningitis). Therefore, before starting antibiotics, the routine evaluation of the newborn for a urinary tract infection will include a urine analysis and urine culture, a routine complete blood count (CBC), a culture of the blood, and a culture of spinal fluid (obtained by a spinal tap) to look for meningitis. Although these tests sound painful, in fact infants tolerate the temporary discomfort well, and the risk of untreated illness far exceeds the risks and discomfort of these procedures. Treatment If your newborn infant develops a urinary tract infection, he most likely will need to be treated with intravenous (in the vein) antibiotics in the hospital just as he would be treated for a bloodstream infection. His healthcare provider will select antibiotics that are most effective for the type of bacteria causing his infection. The exact length of therapy will depend on whether or not he also has bacteria in his bloodstream or elsewhere in his body (e.g., meningitis), but usually is at least 10 days. Since most of these infections can be readily treated, the increased risk of urinary tract infections in uncircumcised newborn males does not necessarily warrant circumcision. Evaluation for urinary tract abnormalities If your child's infection was limited to his urinary tract, it may well be the last one he has. However, because UTIs in young children, particularly newborn males, may be the first and only sign of a structural problem in the urinary tract, his healthcare provider will use ultrasound and/or other imaging procedures to look at the anatomy of his urinary tract. Early diagnosis and correction of an abnormality can prevent recurrent urinary tract infections and subsequent permanent kidney damage. Outlook Most newborns respond well to treatment and do not go on to have recurrent urinary tract infections. Those born with abnormalities of their urinary tract anatomy must be followed closely and evaluated for possible repair of their problem. Sometimes newborns who are born without abnormalities or their urinary tracts develop them as a result of the infection, and subsequently they too are prone to recurrent problems. Whether the abnormalities are congenital or due to the infection, these children should be followed closely because recurrent urinary tract infections lead to permanent kidney damage and other complications such as high blood pressure (hypertension).
| |  | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| About Us |
Contact Us |
Our Partners Privacy Policy | Ethics | Advertising Policy | Terms of Service © Copyright 2004 The Dr. Spock Company. All Rights Reserved. THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The information drSpock.com
provides is for educational purposes only and is not a substitute for
professional medical advice. Always seek the advice of your health care
professional if you have a specific health concern. Mention or advertisement
of any product, service, or brand does not constitute endorsement, guarantee,
or recommendation by The Dr. Spock Company. Please read our full
Terms of Service. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
