Newborn urinary tract infection

　　Newborn urinary tract infections can be caused by various pathogenic bacteria. The most common cause is Escherichia coli infection, followed by Paracoccus, Proteus, Aerobacter, Streptococcus, Klebsiella, Pseudomonas aeruginosa, Staphylococcus, Salmonella typhimurium, and others. Occasionally, it can be caused by mycoplasma, virus, or fungus. Pathogenic bacteria can enter the human body and cause disease through blood infection, ascending infection, lymphatic infection, and direct infection.

　　In addition to its clinical manifestations, newborn urinary tract infections can also lead to other diseases. This disease can be complicated by jaundice, convulsions, abdominal distension, and other diseases, which should attract the attention of parents and doctors.

　　The symptoms of urinary tract infections in the neonatal period are not typical. Clinically, one should be highly vigilant when related symptoms appear. The children may have clinical manifestations such as fever, among whom 70% have a body temperature above 39℃. 60% of the children are irritable; 50% of the children have feeding difficulties; 40% of the children have vomiting or diarrhea.

　　Newborn urinary tract infections should be prevented by carefully handling the baby's external genitalia. The baby's diapers should be cleaned frequently, and the baby's towels and other items should be separated from those of adults. Since the disease is prone to recurrence, about 50% of the patients are asymptomatic, so regular follow-up of the patients is necessary. After the acute course is completed, follow-up should be conducted once a month for a total of 3 months, and no recurrence can be considered as cured. Recurrent cases should be re-examined every 3 to 6 months, lasting for 2 years or longer.

　　The main examination methods for neonatal urinary tract infections are mainly urine tests. After the urine sediment is deposited, the sediment is examined under a microscope. If the white blood cells are more than 10 per high-power field, or if the urine specimen is not centrifuged, and the white blood cells are more than 5 per high-power field, it should be considered as a urinary tract infection. Bacterial colony count greater than 105/ml suggests infection and can confirm the disease. If more than one bacterium can be found in each field under the oil lens, it indicates that the bacteria in the urine are more than 100,000/ml, which has diagnostic significance.

　　Newborns with urinary tract infections should drink plenty of water, as increasing urine volume can reduce the time bacteria stay in the urinary tract, promoting the excretion of bacteria and bacterial toxins. In addition, sufficient heat, abundant protein, vitamins, and easily digestible food should be provided to enhance the body's resistance. For children with fever, a liquid or semi-liquid diet should be given.

　　For newborns suspected of having urinary tract infections, broad-spectrum antibiotic treatment should be administered, and attention should be paid to the presence of abnormalities such as urinary tract obstruction. Therefore, the treatment of neonatal urinary tract infections mainly includes the following two aspects:

　　1. Drug Treatment

　　After urine culture, antibiotics against Gram-negative bacteria should be administered intravenously immediately. Ampicillin (ampicillin) and aminoglycosides are the most commonly used antibiotics.

　　2. Treatment of Urinary Tract Obstruction

　　Since antibiotics can reach the infected site through the urine stream, early anti-infection treatment is effective for most children. For newborns with acute pyelonephritis, if the fever does not subside after 72 hours of anti-infection treatment, it should be suspected that there is a potential obstruction. It is known that newborns with urinary tract obstruction who develop urinary system infections should undergo percutaneous nephrostomy if necessary. For newborns with urinary system infections, if there is a suspicion of congenital urinary tract malformation, urinary tract obstruction, and vesicoureteral reflux, prophylactic antibiotic treatment (ampicillin 12.5mg/kg per day) should be administered after the acute infection is controlled, until radiographic imaging rules out the possibility of these diseases.