Evaluation of Urinary Tract Infection in Newborns with Jaundice in South of Iran

Background: neonatal jaun diceis clinically presented in 60%of full-term newborns. about 8% of newborn s with j aundicehave urinary tract infection (uti) without any other clinicalsigns in favor of uti. in present study we evaluated clinical andparaclinical data that help to rapid and early diagnosis of uti inapparently healthy newborns with jaundice.methods: from february to august 2006, 51 apparently healthyfull-term newborns with ja undice and uti who had been admittedfor management of jaundice in motahary hospital, jahrom(south of iran), were studied and compared with 56 neonates withjaundi ce but without uti. all the neonates had not any othersymptoms such as fever or lethargy. at the time of admission,total and direct bilirubin, coombs' test, mother and neonate bloodgroup, urinalysis and urine culture were requested.results: there was no significant difference of gestationalage, birth weight , age of admission, age at the time of startingjaundice, and total serum bilirubin between the two groups.there was s ignificant differ ence of dire ct bilirubin level, meanof decrease serum bilirubin after 24 hours, gender, and bloodgroups. male gender with mean decrea se of bilirubin less than2.2 mg/dl after 24 hours phototh erapy and direct bilirubinmore than 1.6 mg/dl ,during the first two weeks of neonatalperiod has about 7 times more risk for uti. the presence ofthose three above mentioned factors had only 30% sensitivityand more than 94% specificity for suspicious of uti in asymptomaticneonates with jaundice.conclusion: jaundice may be the only presenting sign of utiin newborns, so according to high specificity for the presenceof three below factorss imultaneously, it seems better toevalu ate newborns for uti if they have high level of directbilirubin (more than j.6 mg/dl ), slow decrease in serumbilirubin level with phototh erapy ( less than 2.2mg/dl/day) especially in male newborn with blood group b.