Do infants in the neonatal intensive care unit diagnosed with urinary tract infection need a routine voiding cystourethrogram?

TitleDo infants in the neonatal intensive care unit diagnosed with urinary tract infection need a routine voiding cystourethrogram?
Publication TypeJournal Article
Year of Publication2017
AuthorsFlannery DD, Brandsma E, Saslow J, Mackley AB, Paul DA, Aghai ZH
JournalJ Matern Fetal Neonatal Med
Pagination1-6
Date Published2017 Dec 20
ISSN1476-4954
Abstract

OBJECTIVE: To determine if infants diagnosed with urinary tract infection (UTI) in the neonatal intensive care unit (NICU) require a routine voiding cystourethrogram (VCUG).

STUDY DESIGN: Retrospective data analysis from three centers for infants admitted to the NICU born between 2000 and 2013 and diagnosed with UTI.

RESULTS: One hundred twenty-six infants from three centers were diagnosed with UTI during their hospitalization. Renal ultrasound (RUS) was performed in 115 infants (91.2%), of which 69 (60%) were abnormal. Mild to moderate hydronephrosis or pelviectasis were the most common abnormalities identified (nā€‰=ā€‰34, 30%). There were 14 infants (12%) with severe abnormalities on RUS. VCUG was performed in 71 infants (56%), of which 3 (4%) were interpreted as abnormal with grade 2 vesicoureteral reflux (VUR) or less (two infants were with normal RUS and one infant was with abnormal RUS).

CONCLUSIONS: More than 50% of infants with a UTI had an abnormal RUS but severe abnormalities were found only in 11% of infants. Only 4% of infants with UTI had VUR; none of these infants had severe VUR on VCUG. A routine VCUG after UTI in the NICU has a low yield and may be reserved for infants with severe or persistent abnormalities on RUS.

DOI10.1080/14767058.2017.1416352
Alternate JournalJ. Matern. Fetal. Neonatal. Med.
PubMed ID29226740