Abstract

Predicting Urinary Tract Infection in Jaundiced Newborns by Phototherapy Response

Objective: This study aimed to compare the post-phototherapy decrease in Serum Total Bilirubin (STB) levels of newborns diagnosed to have idiopathic pathologic hyperbilirubinemia with and without Urinary Tract Infection (UTI) and to determine a critical cut-off value of percent decrease in STB with phototherapy in predicting the diagnosis of UTI. Methods: Urine samples for microscopic examination and bacteriologic culture were obtained in 381 newborns of whom all other possible etiologic causes of neonatal hyperbilirubinemia were excluded. Newborns with and without positive urine culture (Groups I and II) were compared concerning demographic findings and laboratory data. The Receiver Operating Characteristic (ROC) curve was constituted. Results: Post-phototherapy STB level was significantly higher (P=0.0002) and the decrease in STB level with phototherapy was significantly lower (P<0.0001) in Group I when compared to Group II. The critical cut-off value of STB decrease in predicting UTI was 47.9%. Conclusions: A relatively inadequate phototherapy response (STB decrease of <47.9%) should raise the suspicion of UTI, and further urine examinations should be performed considering that 40% of newborns with a decrease of <47.9% in STB despite phototherapy may have UTI and 90% of those with a decrease of ≥ 47.9% do not have UTI

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