Analysis of Clinical Features and Pathogen Characteristics of Urinary Tract Infections in Neonates: A Retrospective Study

Purpose: Urinary tract infections (UTIs) in neonates pose notable challenges in diagnosis and management because of non-specific clinical manifestations and unique physiological characteristics. Understanding the clinical features and pathogen characteristics of UTIs in this population is crucial for tailored diagnostic and therapeutic strategies. This study aimed to investigate varying clinical features and pathogen characteristics of UTIs, thereby offering a holistic perspective on the multifaceted aspects of UTIs in neonates.

Methods: We retrospectively analysed the clinical data of 57 neonates with UTIs admitted to the neonatology department of our hospital from December 2013 to December 2023. Examination methods included aseptic urine collection for bacterial culture, urinalysis and blood tests.

Results: The study revealed that the majority of UTI cases in neonates were initial infections (54.39%), with 45.61% experiencing second or more episodes. Clinical characteristics varied based on gestational age, with premature infants exhibiting a higher incidence of fever (85.71%) compared with full-term and large-for-gestational-age infants. Urinary system malformations were prevalent, with pelviureteric junction obstruction being the most common (29.82%). Urinalysis indicated a high prevalence of positive nitrite tests (59.65%) and elevated white blood cell counts. The 57 presented 2 mixed infection (bacterial colony = 59). Pathogenic bacteria analysis revealed Escherichia coli (40.68%) and Enterococcus spp. (33.90%) as the most prevalent strains. Antibiotic susceptibility testing showed varying susceptibility profiles among bacterial species, emphasising the importance of tailored antibiotic selection based on resistance patterns.

Conclusions: This study provides valuable insights into the diverse clinical presentations, bacterial aetiology and antimicrobial resistance patterns of UTIs in neonates. The findings underscore the critical need for tailored approaches to diagnosis, management and prevention of UTIs in neonates, taking into account their unique characteristics and the complex nature of UTIs in this vulnerable patient population.