Management and outcome of positive urine cultures in a neonatal intensive care unit

Abstract

Objectives: The aim of this study was to describe the management and outcome of positive urine cultures in a neonatal intensive care unit (NICU). Study design: A chart review was completed of infants born October 1, 2004 to December 31, 2006 and admitted to the NICU at the Royal Alexandra Hospital, Edmonton, Alberta with any growth of bacteria or fungi in urine. Results: Positive urine cultures were obtained in 64 of 2936 admissions (2%) and were classified as contaminated urines (n = 34), possible urinary tract infection (UTI) (n = 14), definite UTI (n = 10), and candidal UTI (n = 6). Management was inconsistent. Two children required new assisted ventilation but no other complications occurred. Conclusions: The diagnosis of UTI in NICU is hampered by use of urine collection methods that are subject to contamination. Outcome is generally excellent, but there is a great need for guidelines on management of positive urine cultures in the NICU. Keywords: Urinary tract infection, Candiduria, Neonatal intensive care unit contamination