Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital

Abstract

Background Urine culture, as part of a full septic work-up for late-onset neonatal sepsis, was not routinely done in the Neona- tal Ward at Cipto Mangunkusumo Hospital, and as of today, the prevalence of urinary tract infection (UTI) among neonates with late-onset sepsis remains unknown. Objectives To determine the prevalence and microbiological pat- terns of UTI among late-onset neonatal sepsis in Cipto Mangunkusumo Hospital. Methods We conducted a cross-sectional study on all neonates diagnosed as suspected late-onset sepsis who underwent sep- sis evaluation between 20 October 2003 – 30 April 2004. Urine specimens were collected by bladder catheterization for culture and urinalysis. Results UTI was found in 14.9% (7/47) neonates who under- went urine culture (male: female ratio was 5:2). Six subjects who had UTI were preterm neonates, Klebsiella pneumoniae was found in both blood and urine cultures of 1 subject, while the others showed different microorganisms. Forty-five out of 47 subjects, who were suspected of late-onset sepsis, had posi- tive blood cultures. All subjects with UTI had positive bacteriuria from Gram-stained specimen. Conclusions The prevalence of UTI among neonates with late- onset sepsis in Cipto Mangunkusumo Hospital was 14.9%. The microorganisms most frequently found in urine cultures were Pseudomonas sp., Staphylococcus epidermidis, and Klebsiella pneumoniae. Urine culture, urinalysis, and urinary Gram-stain should be performed as part of sepsis evaluation for late-onset neonatal sepsis, especially in male and preterm neonates

Keywords

• urinary tract infection
• late-onset sepsis
• neonate