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 language | English (US) |
|---|---|
| Pages (from-to) | 583-586 |
| Number of pages | 4 |
| Journal | Early Human Development |
| Volume | 91 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2015 |
Funding
Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001117 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, which had no role in study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the manuscript for publication. The first author wrote the first draft of the manuscript (no honorarium/grant/specific payment received). Dr. Seed receives support from the National Institutes of Health and the U.S. Department of Health and Human Services ( NIGMS 1R01GM108494-01 ), the Department of Defense ( W81XWH-13-1-0450 ), The Hartwell Foundation , and the March of Dimes ( 6-FY12-277 ). Dr. Cotten receives salary support from the U.S. Department of Health and Human Services ( DHHS-1R18AE000028-01 ). Dr. Laughon receives support from the U.S. government for his work in pediatric and neonatal clinical pharmacology (Government Contract HHSN267200700051C , PI: Benjamin, under the Best Pharmaceuticals for Children Act) and from the Eunice Kennedy Shriver National Institute of Child Health and Human Development ( 5K23HD068497-01 ). Dr. Smith receives salary support for research from the National Institutes of Health and the U.S. Department of Health and Human Services ( NICHD 1K23HD060040-01 and DHHS-1R18AE000028-01 ); he also receives research support from industry for neonatal and pediatric drug development ( www.dcri.duke.edu/research/coi.jsp ). L.C.P., C.P.H., M.B., and R.H.C. have no relevant conflicts to disclose.
Keywords
- Necrotizing enterocolitis
- Neonatal
- Urinary tract infection
ASJC Scopus subject areas
- Obstetrics and Gynecology
- Pediatrics, Perinatology, and Child Health