Association between positive urine cultures and necrotizing enterocolitis in a large cohort of hospitalized infants

Leslie C. Pineda, Christoph P. Hornik, Patrick C. Seed, C. Michael Cotten, Matthew M. Laughon, Margarita Bidegain, Reese H. Clark, P. Brian Smith*

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: We used a large research database to examine the association between urinary tract infections and necrotizing enterocolitis (NEC) in premature infants. Methods: This retrospective data analysis included infants ≤. 32. week gestational age and ≤. 1500. g at birth who had urine cultures obtained at one of 322 neonatal intensive care units managed by the Pediatrix Medical Group from 1997 to 2012. The primary outcome was a diagnosis of NEC within 7. days after urine culture. We used multivariable conditional logistic regression conditioned on postnatal age and controlling for gestational age, inotropic support on the day of culture, and mechanical ventilation on the day of culture to evaluate the association between urine culture result and NEC. Results: We identified 25,816 infants who had 43,556 urine cultures obtained; 6586 (15.1%) of the cultures were positive. A diagnosis of NEC within 7. days after culture was made in 334 (5.1%) of the 6586 positive cultures versus 1582 (4.3%) of the 36,970 negative cultures (p < 0.01). On multivariable analysis, infants with any positive urine culture had increased risk of NEC (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02-1.31); the risk was higher when limited to Gram-negative organisms (OR 1.37, 95% CI 1.17-1.59). The risk of surgical NEC was increased in infants with any positive urine culture (OR 1.46, 95% CI 1.18-1.81) and was also higher when limited to Gram-negative organisms (OR 1.99, 95% CI 1.53-2.59). Conclusion: Positive urine cultures were associated with increased risk of NEC within 7. days of culture.

Original languageEnglish (US)
Pages (from-to)583-586
Number of pages4
JournalEarly Human Development
Volume91
Issue number10
DOIs
StatePublished - Oct 1 2015

Fingerprint

Necrotizing Enterocolitis
Urine
Odds Ratio
Confidence Intervals
Gestational Age
Neonatal Intensive Care Units
Artificial Respiration
Premature Infants
Urinary Tract Infections
Logistic Models
Parturition
Databases
Research

Keywords

  • Necrotizing enterocolitis
  • Neonatal
  • Urinary tract infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Pineda, Leslie C. ; Hornik, Christoph P. ; Seed, Patrick C. ; Cotten, C. Michael ; Laughon, Matthew M. ; Bidegain, Margarita ; Clark, Reese H. ; Brian Smith, P. / Association between positive urine cultures and necrotizing enterocolitis in a large cohort of hospitalized infants. In: Early Human Development. 2015 ; Vol. 91, No. 10. pp. 583-586.
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title = "Association between positive urine cultures and necrotizing enterocolitis in a large cohort of hospitalized infants",
abstract = "Objective: We used a large research database to examine the association between urinary tract infections and necrotizing enterocolitis (NEC) in premature infants. Methods: This retrospective data analysis included infants ≤. 32. week gestational age and ≤. 1500. g at birth who had urine cultures obtained at one of 322 neonatal intensive care units managed by the Pediatrix Medical Group from 1997 to 2012. The primary outcome was a diagnosis of NEC within 7. days after urine culture. We used multivariable conditional logistic regression conditioned on postnatal age and controlling for gestational age, inotropic support on the day of culture, and mechanical ventilation on the day of culture to evaluate the association between urine culture result and NEC. Results: We identified 25,816 infants who had 43,556 urine cultures obtained; 6586 (15.1{\%}) of the cultures were positive. A diagnosis of NEC within 7. days after culture was made in 334 (5.1{\%}) of the 6586 positive cultures versus 1582 (4.3{\%}) of the 36,970 negative cultures (p < 0.01). On multivariable analysis, infants with any positive urine culture had increased risk of NEC (odds ratio [OR] 1.16, 95{\%} confidence interval [CI] 1.02-1.31); the risk was higher when limited to Gram-negative organisms (OR 1.37, 95{\%} CI 1.17-1.59). The risk of surgical NEC was increased in infants with any positive urine culture (OR 1.46, 95{\%} CI 1.18-1.81) and was also higher when limited to Gram-negative organisms (OR 1.99, 95{\%} CI 1.53-2.59). Conclusion: Positive urine cultures were associated with increased risk of NEC within 7. days of culture.",
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Pineda, LC, Hornik, CP, Seed, PC, Cotten, CM, Laughon, MM, Bidegain, M, Clark, RH & Brian Smith, P 2015, 'Association between positive urine cultures and necrotizing enterocolitis in a large cohort of hospitalized infants', Early Human Development, vol. 91, no. 10, pp. 583-586. https://doi.org/10.1016/j.earlhumdev.2015.07.003

Association between positive urine cultures and necrotizing enterocolitis in a large cohort of hospitalized infants. / Pineda, Leslie C.; Hornik, Christoph P.; Seed, Patrick C.; Cotten, C. Michael; Laughon, Matthew M.; Bidegain, Margarita; Clark, Reese H.; Brian Smith, P.

In: Early Human Development, Vol. 91, No. 10, 01.10.2015, p. 583-586.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between positive urine cultures and necrotizing enterocolitis in a large cohort of hospitalized infants

AU - Pineda, Leslie C.

AU - Hornik, Christoph P.

AU - Seed, Patrick C.

AU - Cotten, C. Michael

AU - Laughon, Matthew M.

AU - Bidegain, Margarita

AU - Clark, Reese H.

AU - Brian Smith, P.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Objective: We used a large research database to examine the association between urinary tract infections and necrotizing enterocolitis (NEC) in premature infants. Methods: This retrospective data analysis included infants ≤. 32. week gestational age and ≤. 1500. g at birth who had urine cultures obtained at one of 322 neonatal intensive care units managed by the Pediatrix Medical Group from 1997 to 2012. The primary outcome was a diagnosis of NEC within 7. days after urine culture. We used multivariable conditional logistic regression conditioned on postnatal age and controlling for gestational age, inotropic support on the day of culture, and mechanical ventilation on the day of culture to evaluate the association between urine culture result and NEC. Results: We identified 25,816 infants who had 43,556 urine cultures obtained; 6586 (15.1%) of the cultures were positive. A diagnosis of NEC within 7. days after culture was made in 334 (5.1%) of the 6586 positive cultures versus 1582 (4.3%) of the 36,970 negative cultures (p < 0.01). On multivariable analysis, infants with any positive urine culture had increased risk of NEC (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02-1.31); the risk was higher when limited to Gram-negative organisms (OR 1.37, 95% CI 1.17-1.59). The risk of surgical NEC was increased in infants with any positive urine culture (OR 1.46, 95% CI 1.18-1.81) and was also higher when limited to Gram-negative organisms (OR 1.99, 95% CI 1.53-2.59). Conclusion: Positive urine cultures were associated with increased risk of NEC within 7. days of culture.

AB - Objective: We used a large research database to examine the association between urinary tract infections and necrotizing enterocolitis (NEC) in premature infants. Methods: This retrospective data analysis included infants ≤. 32. week gestational age and ≤. 1500. g at birth who had urine cultures obtained at one of 322 neonatal intensive care units managed by the Pediatrix Medical Group from 1997 to 2012. The primary outcome was a diagnosis of NEC within 7. days after urine culture. We used multivariable conditional logistic regression conditioned on postnatal age and controlling for gestational age, inotropic support on the day of culture, and mechanical ventilation on the day of culture to evaluate the association between urine culture result and NEC. Results: We identified 25,816 infants who had 43,556 urine cultures obtained; 6586 (15.1%) of the cultures were positive. A diagnosis of NEC within 7. days after culture was made in 334 (5.1%) of the 6586 positive cultures versus 1582 (4.3%) of the 36,970 negative cultures (p < 0.01). On multivariable analysis, infants with any positive urine culture had increased risk of NEC (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.02-1.31); the risk was higher when limited to Gram-negative organisms (OR 1.37, 95% CI 1.17-1.59). The risk of surgical NEC was increased in infants with any positive urine culture (OR 1.46, 95% CI 1.18-1.81) and was also higher when limited to Gram-negative organisms (OR 1.99, 95% CI 1.53-2.59). Conclusion: Positive urine cultures were associated with increased risk of NEC within 7. days of culture.

KW - Necrotizing enterocolitis

KW - Neonatal

KW - Urinary tract infection

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