• An audit of urinary tract infections in very low birth weight infants--what are we missing?

      Perrem, L M; O'Neill, R; O'Grady, M; White, M (Irish Medical Journal, 2015-01)
      Urinary Tract Infections (UTIs) are a leading cause of bacterial infection in infants and the National Institute of Clinical Excellence recommends that UTIs are actively sought in paediatric patients. 1 Their incidence ranges from between 0.1- 2.0% in full-term newborns, increasing to a reported 25% in preterm and very low birth weight (VLBW) infants. 2-4 The urinary tract is an extremely rare source of infection in the first 72 hours of life and thus routine urine culture in this population is deemed unnecessary. 4 Conversely, UTIs frequently present with late-onset sepsis (LOS) in the VLBW population 1,2 and urine culture is an essential element of a complete sepsis evaluation in this cohort. 1,3 Despite a high incidence of UTI, urine culture is frequently neglected in Neonatal Intensive Care Units (NICUs) 3 as obtaining a clean-catch sample is time consuming and the use of invasive second-line collection methods is limited by fear of complications and medical staff procedural inexperience. Identifying the source of infection will influence subsequent radiological investigations 1 and ensure appropriate treatment.