PREVALENCE OF URINARY TRACT INFECTION IN NEONATES ADMITTED IN NEONATAL INTENSIVE CARE UNIT WITH SEPSIS

Abstract

Background: Urinary tract infection (UTI) is an important but potentially underrecognized source of infection in neonates presenting with clinical sepsis. Because neonatal UTI often presents with nonspecific clinical manifestations, microbiological confirmation is essential for accurate diagnosis and appropriate management. Objective: To determine the prevalence of culture-confirmed urinary tract infection among neonates admitted to the neonatal intensive care unit with sepsis. Methods: This cross-sectional study was conducted among 58 neonates aged 0–28 days admitted to the neonatal intensive care unit with clinical suspicion of sepsis. Consecutive sampling was used. Urine samples were collected by sterile transurethral catheterization before initiation of antibiotics and submitted for culture. UTI was defined as growth of >10³ CFU/mL of a single pathogenic organism. Demographic, neonatal, maternal, clinical, and laboratory variables were recorded and analyzed using SPSS version 29. Results: Among the 58 neonates evaluated, 5 (8.6%) had positive urine cultures fulfilling the predefined criterion for UTI, while 53 (91.4%) had negative cultures. Among culture-positive cases, Escherichia coli and Klebsiella pneumoniae each accounted for 40% of isolates, while Enterococcus species accounted for 20%. UTI was observed more frequently among neonates with prematurity, low birth weight, late-onset sepsis, maternal UTI, and urinary catheterization; however, these associations did not reach statistical significance. Conclusion: Culture-confirmed UTI was identified among neonates admitted with clinical sepsis, highlighting the importance of considering urinary infection during neonatal sepsis evaluation. Standardized urine collection before antibiotic administration and appropriate urine culture can facilitate accurate diagnosis and support targeted antimicrobial management.