Urinary tract infection in infants with asymptomatic Jaundice: a meta-analysis UTI and Jaundice Review

INTRODUCTION Infants, especially neonates, present with jaundice with an unclear association with urinary tract infection. Evidence for such association is unclear, especially in a specific group of otherwise well-appearing infants born > 35 weeks. EVIDENCE ACQUISITION Data sources We used the following databases: Medline, Embase, CINAHL Plus, Scopus, and Cochrane library. Study selection We included observational studies that included infants born > 35 weeks gestation, younger than 12 months, asymptomatic other than jaundice, and urinary tract infection. Data extraction: After reviewing the eligibility, two reviewers extracted data and assessed the quality of each study using the Newcastle-Ottawa scale. EVIDENCE SYNTHESIS We analyzed sixteen studies for a total of 2933 infants. The pooled incidence of UTI was 9.6% (95% confidence interval of 6% to 15%). The subgroup analysis failed to show any difference in incidence within the publication year, sample size, study design, study region, urine collection method, and age group. There was no explanation of heterogeneity noted by the meta-regression for UTI incidence with publication year, total bilirubin, sample size, and study quality. The funnel plot and Egger’s test revealed publication bias. CONCLUSIONS Nearly 1 in 10 otherwise asymptomatic infants with jaundice have a UTI. We recommend a rigorous large prospective study to confirm this finding.