Urinary tract infections in young infants with prolonged jaundice

The incidence of urinary tract infections (UTIs) in young infants with jaundice is low, and prolonged jaundice in that setting is even rarer. In this study, we retrospectively reviewed the clinical features of 50 infants (seen from 1984 through 2004) 1 week to 3 months of age who had UTIs and prolonged jaundice and compared them with those of infants with UTIs in a similar age range at our hospital from a published study. The infants in our study had a lower incidence of high fever (12%), were less likely to have pyuria (29%), had fewer Escherichia coli but more Enterococcus species infections, and had more mixed infections (32%) than did the historical control. Klebsiella pneumoniae or Enterococcus species dominated in mixed infections (15/16) but the frequency of E. coli isolates did not differ significantly between mixed and single infections. We conclude that high fever and pyuria are unreliable criteria for screening for UTIs in young infants presenting with prolonged jaundice. Urine cultures should be obtained in such patients to determine whether a UTI is present. Mixed urinary infections, particularly K. pneumoniae and Enterococcus species, may play a key role in this entity.