Factors Affecting Prevalence of Urinary Tract Infection in Neo-nates with Unexplained Hyperbilirubinemia: A Systematic Review and Meta-Analysis Study in Iran
Abstract
Background: The prevalence and risk factors of urinary tract infection (UTI) in neonates with unexplained hyperbilirubinemia are not studied thoroughly. Since the prevalence of UTI is highly variable in different areas and countries, this study aimed to review the existing data of Iranian neonates with UTI presented with unexplained hyperbilirubinemia.
Methods: This study is a meta-analysis of Iranian newborns with unexplained hyperbilirubinemia. We identified all studies indexed in international (Web of Science, PubMed, Scopus, Google Scholar) and national (Science Information Database, Magiran) databases from 2000-2018. Search terms included: Urinary Tract Infections OR UTI AND urine OR culture OR microbio, jaundice OR icter OR hyperbili, AND Iran.
Results: Overall, 4210 neonates from 17 studies were included. The pooled prevalence of UTI in neonates with unexplained hyperbilirubinemia was 6.81% (95% CI: 4.86-8.77). Considering the subgroups analyses; the prevalence of UTI was higher in the prolonged vs. not-prolonged state (8.34% vs. 4.00%), low birth weight vs. normal birth weight (7.81% vs. 4.51%), and exclusive vs. non-exclusive breastfeeding (8.84% vs. 4.72%). Male gender and low birth weight increased the risk of UTI about two times compared to the female gender and normal birth weight, respectively. The results of the analyses in neonates with unconjugated hyperbilirubinemia also showed the above-mentioned subgroup differences.
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13. Stein R, Dogan HS, Hoebeke P, et al (2015). Urinary Tract Infections in Children: EAU/ESPU Guidelines. Eur Urol, 67(3):546-58.
14. Ghafari M, Baigi V, Cheraghi Z, et al (2016). The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis. PLoS One, 11(6):e0158031.
15. Eghbalian F, Monsef AR (2009). Prolonged jaundice as an early manifestation of asymptomatic urinary tract infection. Stud Med Sci, 20(2):98-103.
16. Eslami Z, Ghasemi A (2009). A survey of the urinary tract infection in icteric neonates. Tehran Univ Med J, 66(11):843-847.
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19. Hajebrahim Tehrani F, Valaie N (2004). Incidence of septicemia and urinary tract infection in newborns with jaundice hospitalized in Mofid hospital. Feyz 7(4):58-63.
20. Hematyar M, Emami P (2009). Incidence of urinary tract infection in hospitalized icteric neonates in Javaheri hospital (2003-2006). J Med Counc IR Iran, 27(3):343-348.
21. Jafarzadeh M, Mohammadzadeh A (2009). Should urine culture be considered in the hyperbilirubinemia workup of neonate. J Chin Clin Med, 4(3):136-8.
22. Khalesi N, Sharaky T, Haghighe M (2007). Prevalence of urinary tract infection in neonates with prolonged jaundice referred to Aliasghar Hospital in Zahedan (2005). J Qazvin Univ Med Sci, 11(3):14-8.
23. Maamouri G, Khatami F, Mohammadzadeh A, et al (2013). Hyperbilirubinemia and Neonatal Infection. Int J Pediatr, 1(1):5-12.
24. Mosayebi Z, Movahhedian A (2007). R2327 Urinary tract infection in asymptomatic jaundiced newborns. Int J Antimicrob Agents, 29, Supplement 2:S675.
25. Najati N, Gharebaghi MM, Mortazavi F (2010). Underlying etiologies of prolonged icterus in neonates. Pak J Biol Sci, 13(14):711-4.
26. Pashapour N, Nikibahksh AA, Golmohammadlou S (2007). Urinary tract infection in term neonates with prolonged jaundice. Urol J, 4(2):91-4.
27. Sabzehei MK, Basiri B, Gohari Z, et al (2015). Etiologies of Prolonged Unconjugated Hyperbilirubinemia in Neonates Admitted to Neonatal Wards. Iranian Journal of Neonatology, 6(4):37-42.
28. Shahian M, Rashtian P, Kalani M (2012). Unexplained neonatal jaundice as an early diagnostic sign of urinary tract infection. Int J Infect Dis, 16(7):e487-90.
29. Sharif MR, Madani M (2014). Evaluating the causes of prolonged jaundice among the newborns referred to Kashan Shahid-Beheshti hospital during 2011-2012. Feyz, 18(1):91-96.
30. Sharif MR, Madani M, Kheirkhah D (2014). Urinary tract infection in icteric infants younger than one week. Feyz 18(4):383-8.
31. Zarkesh M, Assl AS, Ramtinfar S, et al (2015). Incidence of hyperbilirubinemia and urinary tract infection (UTI) in asymptomatic term neonates under two weeks of age. Iranian Journal of Neonatology, 6(3):45-48.
32. Shaikh N, Morone NE, Bost JE, et al (2008). Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J, 27(4):302-8.
33. Ginsburg CM, McCracken GH (1982). Urinary tract infections in young infants. Pediatrics, 69(4):409-12.
34. Garcia FJ, Nager AL (2002). Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics, 109(5):846-51.
35. Bilgen H, Ozek E, Unver T, et al (2006). Urinary tract infection and hyperbilirubinemia. Turk J Pediatr, 48(1):51-5.
36. Mutlu M, Cayir Y, Aslan Y (2014). Urinary tract infections in neonates with jaundice in their first two weeks of life. World J Pediatr, 10(2):164-7.
37. Omar C, Hamza S, Bassem AM, et al (2011). Urinary tract infection and indirect hyperbilirubinemia in newborns. North American Journal of Medical Sciences, 3(12):544-7.
38. Xinias I, Demertzidou V, Mavroudi A, et al (2009). Bilirubin levels predict renal cortical changes in jaundiced neonates with urinary tract infection. World J Pediatr, 5(1):42-5.
39. Malla T, Sathian B, Malla K, et al (2016). Urinary tract infection in asymptomatic newborns with prolonged unconjugated hyperbilirubunemia: a hospital based observational study from Western Region of Nepal. Kathmandu Univ Med J (KUMJ), 14(53):41-46.
40. Maisels MJ, Bhutani VK, Bogen D, et al (2009). Hyperbilirubinemia in the newborn infant > or =35 weeks' gestation: an update with clarifications. Pediatrics, 124(4):1193-8.
41. Baracco R, Mattoo TK (2014). Diagnosis and management of urinary tract infection and vesicoureteral reflux in the neonate. Clin Perinatol, 41(3):633-42.
42. Kanellopoulos TA, Salakos C, Spiliopoulou I, et al (2006). First urinary tract infection in neonates, infants and young children: a comparative study. Pediatr Nephrol, 21(8):1131-7.
2. Becknell B, Schober M, Korbel L, et al (2015). The diagnosis, evaluation and treatment of acute and recurrent pediatric urinary tract infections. Expert Rev Anti Infect Ther, 13(1):81-90.
3. Kasap B, Soylu A, Kavukçu S (2014). Relation between hyperbilirubinemia and urinary tract infections in the neonatal period. J Nephrol Therapeutic, S11-009.
4. Ozcan M, Sarici SU, Yurdugul Y, et al (2017). Association Between Early Idiopathic Neonatal Jaundice and Urinary Tract Infections. Clin Med Insights Pediatr, 11:1179556517701118.
5. Subcommittee on Hyperbilirubinemia (2004). Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics, 114(1):297-316.
6. National Institute for Health and Care Excellence (NICE) (2010). Jaundice in newborn babies under 28 days. Clinical guideline [cg98]. https://www.nice.org.uk/guidance/cg98
7. Chen HT, Jeng MJ, Soong WJ, et al (2011). Hyperbilirubinemia with urinary tract infection in infants younger than eight weeks old. J Chin Med Assoc, 74(4):159-63.
8. Simoes e Silva AC, Oliveira EA (2015). Update on the approach of urinary tract infection in childhood. J Pediatr (Rio J), 91:S2-10.
9. Steadman S, Ahmed I, McGarry K, et al (2016). Is screening for urine infection in well infants with prolonged jaundice required? Local review and meta-analysis of existing data. Arch Dis Child, 101(7):614-9.
10. Tola HH, Ranjbaran M, Omani-Samani R, et al (2018). Prevalence of UTI among Iranian infants with prolonged jaundice, and its main causes: A systematic review and meta-analysis study. J Pediatr Urol, 14(2):108-115.
11. Moher D, Liberati A, Tetzlaff J, et al (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 339:b2535.
12. Munn Z, Moola S, Riitano D, et al (2014). The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. Int J Health Policy Manag, 3(3):123-128.
13. Stein R, Dogan HS, Hoebeke P, et al (2015). Urinary Tract Infections in Children: EAU/ESPU Guidelines. Eur Urol, 67(3):546-58.
14. Ghafari M, Baigi V, Cheraghi Z, et al (2016). The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis. PLoS One, 11(6):e0158031.
15. Eghbalian F, Monsef AR (2009). Prolonged jaundice as an early manifestation of asymptomatic urinary tract infection. Stud Med Sci, 20(2):98-103.
16. Eslami Z, Ghasemi A (2009). A survey of the urinary tract infection in icteric neonates. Tehran Univ Med J, 66(11):843-847.
17. Fallahi M, Basir MF, Kolaee M (2009). Incidence of sepsis in neonates with indirect hyperbilirubinemia in Shohadaye Tajrish Hospital. Pejouhandeh, 14(1).
18. Ghaemi S, Fesharaki RJ, Kelishadi R (2007). Late onset jaundice and urinary tract infection in neonates. Indian J Pediatr, 74(2):139-41.
19. Hajebrahim Tehrani F, Valaie N (2004). Incidence of septicemia and urinary tract infection in newborns with jaundice hospitalized in Mofid hospital. Feyz 7(4):58-63.
20. Hematyar M, Emami P (2009). Incidence of urinary tract infection in hospitalized icteric neonates in Javaheri hospital (2003-2006). J Med Counc IR Iran, 27(3):343-348.
21. Jafarzadeh M, Mohammadzadeh A (2009). Should urine culture be considered in the hyperbilirubinemia workup of neonate. J Chin Clin Med, 4(3):136-8.
22. Khalesi N, Sharaky T, Haghighe M (2007). Prevalence of urinary tract infection in neonates with prolonged jaundice referred to Aliasghar Hospital in Zahedan (2005). J Qazvin Univ Med Sci, 11(3):14-8.
23. Maamouri G, Khatami F, Mohammadzadeh A, et al (2013). Hyperbilirubinemia and Neonatal Infection. Int J Pediatr, 1(1):5-12.
24. Mosayebi Z, Movahhedian A (2007). R2327 Urinary tract infection in asymptomatic jaundiced newborns. Int J Antimicrob Agents, 29, Supplement 2:S675.
25. Najati N, Gharebaghi MM, Mortazavi F (2010). Underlying etiologies of prolonged icterus in neonates. Pak J Biol Sci, 13(14):711-4.
26. Pashapour N, Nikibahksh AA, Golmohammadlou S (2007). Urinary tract infection in term neonates with prolonged jaundice. Urol J, 4(2):91-4.
27. Sabzehei MK, Basiri B, Gohari Z, et al (2015). Etiologies of Prolonged Unconjugated Hyperbilirubinemia in Neonates Admitted to Neonatal Wards. Iranian Journal of Neonatology, 6(4):37-42.
28. Shahian M, Rashtian P, Kalani M (2012). Unexplained neonatal jaundice as an early diagnostic sign of urinary tract infection. Int J Infect Dis, 16(7):e487-90.
29. Sharif MR, Madani M (2014). Evaluating the causes of prolonged jaundice among the newborns referred to Kashan Shahid-Beheshti hospital during 2011-2012. Feyz, 18(1):91-96.
30. Sharif MR, Madani M, Kheirkhah D (2014). Urinary tract infection in icteric infants younger than one week. Feyz 18(4):383-8.
31. Zarkesh M, Assl AS, Ramtinfar S, et al (2015). Incidence of hyperbilirubinemia and urinary tract infection (UTI) in asymptomatic term neonates under two weeks of age. Iranian Journal of Neonatology, 6(3):45-48.
32. Shaikh N, Morone NE, Bost JE, et al (2008). Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J, 27(4):302-8.
33. Ginsburg CM, McCracken GH (1982). Urinary tract infections in young infants. Pediatrics, 69(4):409-12.
34. Garcia FJ, Nager AL (2002). Jaundice as an early diagnostic sign of urinary tract infection in infancy. Pediatrics, 109(5):846-51.
35. Bilgen H, Ozek E, Unver T, et al (2006). Urinary tract infection and hyperbilirubinemia. Turk J Pediatr, 48(1):51-5.
36. Mutlu M, Cayir Y, Aslan Y (2014). Urinary tract infections in neonates with jaundice in their first two weeks of life. World J Pediatr, 10(2):164-7.
37. Omar C, Hamza S, Bassem AM, et al (2011). Urinary tract infection and indirect hyperbilirubinemia in newborns. North American Journal of Medical Sciences, 3(12):544-7.
38. Xinias I, Demertzidou V, Mavroudi A, et al (2009). Bilirubin levels predict renal cortical changes in jaundiced neonates with urinary tract infection. World J Pediatr, 5(1):42-5.
39. Malla T, Sathian B, Malla K, et al (2016). Urinary tract infection in asymptomatic newborns with prolonged unconjugated hyperbilirubunemia: a hospital based observational study from Western Region of Nepal. Kathmandu Univ Med J (KUMJ), 14(53):41-46.
40. Maisels MJ, Bhutani VK, Bogen D, et al (2009). Hyperbilirubinemia in the newborn infant > or =35 weeks' gestation: an update with clarifications. Pediatrics, 124(4):1193-8.
41. Baracco R, Mattoo TK (2014). Diagnosis and management of urinary tract infection and vesicoureteral reflux in the neonate. Clin Perinatol, 41(3):633-42.
42. Kanellopoulos TA, Salakos C, Spiliopoulou I, et al (2006). First urinary tract infection in neonates, infants and young children: a comparative study. Pediatr Nephrol, 21(8):1131-7.
| Files | ||
| Issue | Vol 50 No 7 (2021) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v50i7.6617 | |
| Keywords | ||
| Urinary tract infection Neonates Hyperbilirubinemia Systematic review Meta-analysis Iran | ||
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How to Cite
1.
Bagheri Amiri F, Tavasoli S, Borumandnia N, Taheri M. Factors Affecting Prevalence of Urinary Tract Infection in Neo-nates with Unexplained Hyperbilirubinemia: A Systematic Review and Meta-Analysis Study in Iran. Iran J Public Health. 2021;50(7):1311-1323.
