Question:
A 10-day-old neonate presents with jaundice, poor feeding, fever, and hepatomegaly. Urine shows pyuria and culture is pending. Which of the following is the most common causative organism of UTI in this child?
A 10-day-old neonate presents with jaundice, poor feeding, fever, and hepatomegaly. Urine shows pyuria and culture is pending. Which of the following is the most common causative organism of UTI in this child?
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Most common cause of UTI across ALL pediatric age groups (neonates, infants, children) = Escherichia coli ($>75\%$). Neonatal UTI frequently presents with unexplained prolonged jaundice!
Updated On: Sep 3, 2026
- Klebsiella pneumoniae
- Escherichia coli
- Enterococcus faecalis
- Proteus mirabilis
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The Correct Option is B
Solution and Explanation
Concept:
Urinary Tract Infection (UTI) in the neonatal period is a serious systemic bacterial infection, often occurring in the setting of bacteremia or underlying congenital anomalies of the kidney and urinary tract (CAKUT).
Neonates present with non-specific systemic signs such as unexplained jaundice (conjugated or unconjugated), fever or hypothermia, poor feeding, lethargy, and vomiting.
Explanation:
• Across all pediatric age groups, including the neonatal period, Escherichia coli is overwhelmingly the most common causative uropathogen, responsible for $75\text{ to 80\%$} of all community-acquired and neonatal urinary tract infections.
• Uropathogenic E. coli (UPEC) possesses specialized virulence factors, including P-fimbriae (pyelonephritis-associated pili), type 1 fimbriae, and hemolysin, allowing adhesion to uroepithelial cells and ascending migration against urinary flow.
• Other uropathogens accounting for the remaining minority of neonatal cases include Klebsiella pneumoniae, Enterococcus faecalis, Group B Streptococcus (GBS), Proteus mirabilis, and Pseudomonas aeruginosa.
• Jaundice in neonatal UTI is mediated by bacterial endotoxins and inflammatory cytokines causing microcanalicular cholestasis and hemolysis.
• Due to the high incidence of structural urinary anomalies in neonates with UTI, renal and bladder ultrasonography (RBUS) is mandatory after initiating parenteral antibiotic therapy.
Final Answer:
Escherichia coli is the most frequent pathogen causing urinary tract infection in neonates.
Urinary Tract Infection (UTI) in the neonatal period is a serious systemic bacterial infection, often occurring in the setting of bacteremia or underlying congenital anomalies of the kidney and urinary tract (CAKUT).
Neonates present with non-specific systemic signs such as unexplained jaundice (conjugated or unconjugated), fever or hypothermia, poor feeding, lethargy, and vomiting.
Explanation:
• Across all pediatric age groups, including the neonatal period, Escherichia coli is overwhelmingly the most common causative uropathogen, responsible for $75\text{ to 80\%$} of all community-acquired and neonatal urinary tract infections.
• Uropathogenic E. coli (UPEC) possesses specialized virulence factors, including P-fimbriae (pyelonephritis-associated pili), type 1 fimbriae, and hemolysin, allowing adhesion to uroepithelial cells and ascending migration against urinary flow.
• Other uropathogens accounting for the remaining minority of neonatal cases include Klebsiella pneumoniae, Enterococcus faecalis, Group B Streptococcus (GBS), Proteus mirabilis, and Pseudomonas aeruginosa.
• Jaundice in neonatal UTI is mediated by bacterial endotoxins and inflammatory cytokines causing microcanalicular cholestasis and hemolysis.
• Due to the high incidence of structural urinary anomalies in neonates with UTI, renal and bladder ultrasonography (RBUS) is mandatory after initiating parenteral antibiotic therapy.
Final Answer:
Escherichia coli is the most frequent pathogen causing urinary tract infection in neonates.
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