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Child Suffering From Jaundice, Weight Loss, Uti. Photo Therapy Given. Urine Culture Showed Klebsiella Pnumoniae. MCU Required?
my child is one month old.at the age of 15 days he was suffered from jaundice, weight loss & uncomplicated uti.Drs given phototherapy for 2 days and his weight increased by 150 gms with in 2 days.Drs also said this may be a case of inadequate feeding.after urine culture report which came on 3rd day of the admission they started meropenum for 7 days.outcome of report was Klebsiella pnumoniae was present and with 10 raise to power 3 colony form unit.Then they discharged the child.For follow up they suggested for ultrasound after one week and MCU after 4 weeks of discharge.His ultrasound is ok now.But can u suggest is MCU necessary if yes then why as child is fine now?And from where child got this infection as we were taking care with cautious.
Wed, 20 Nov 2013
Hello,
Your child was diagnosed to have urinary tract infection based on urine culture report. Please ask the doctors who were treating your child, the method of urine collection. There are 3 methods of urine collection in a neonate - suprapubic aspiration, urethral catheterization and collection from urine bag. The result of your child is consistent with diagnosis of UTI only if urine was collected by suprapubic aspiration . In the other two methods you can diagnose UTI when colony forming units are more than 5*10 raised to power 4 in case of urethral catheterization and more than 10 raised to power 5 in bag collection. If urine was not collected by suprapubic aspiration then you have no reason to worry.
But if the diagnosis is correct, MCU is required. MCU helps in diagnosing vesicoreteral reflux and posterior urethral valves (May sound like big words to you). Basically these conditions predispose the child to develop urinary tract infections and depending on their severity may require a surgical procedure/prophylactic antibiotibics/ close follow up. Diagnosing these conditions on time can prevent further attacks of UTI and kidney damage. As per your question to the cause of UTI - it could be due to an underlying defect in the urinary tract or a manifestation of septicemia/bacteremia.
Hope that helps.
If you have any more queries I will be glad to help you out.
Regards,
Dr. Preeti
Your child was diagnosed to have urinary tract infection based on urine culture report. Please ask the doctors who were treating your child, the method of urine collection. There are 3 methods of urine collection in a neonate - suprapubic aspiration, urethral catheterization and collection from urine bag. The result of your child is consistent with diagnosis of UTI only if urine was collected by suprapubic aspiration . In the other two methods you can diagnose UTI when colony forming units are more than 5*10 raised to power 4 in case of urethral catheterization and more than 10 raised to power 5 in bag collection. If urine was not collected by suprapubic aspiration then you have no reason to worry.
But if the diagnosis is correct, MCU is required. MCU helps in diagnosing vesicoreteral reflux and posterior urethral valves (May sound like big words to you). Basically these conditions predispose the child to develop urinary tract infections and depending on their severity may require a surgical procedure/prophylactic antibiotibics/ close follow up. Diagnosing these conditions on time can prevent further attacks of UTI and kidney damage. As per your question to the cause of UTI - it could be due to an underlying defect in the urinary tract or a manifestation of septicemia/bacteremia.
Hope that helps.
If you have any more queries I will be glad to help you out.
Regards,
Dr. Preeti
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