Management and outcome of positive urine cultures in a neonatal intensive care unit

ObjectivesThe aim of this study was to describe the management and outcome of positive urine cultures in a neonatal intensive care unit (NICU).Study designA chart review was completed of infants born October 1, 2004 to December 31, 2006 and admitted to the NICU at the Royal Alexandra Hospital, Edmonton, Alberta with any growth of bacteria or fungi in urine.ResultsPositive urine cultures were obtained in 64 of 2936 admissions (2%) and were classified as contaminated urines (n = 34), possible urinary tract infection (UTI) (n = 14), definite UTI (n = 10), and candidal UTI (n = 6). Management was inconsistent. Two children required new assisted ventilation but no other complications occurred.ConclusionsThe diagnosis of UTI in NICU is hampered by use of urine collection methods that are subject to contamination. Outcome is generally excellent, but there is a great need for guidelines on management of positive urine cultures in the NICU.