Can circumcision prevent recurrent urinary tract infections in hospitalized infants?

Urinary tract infection (UTI) is an uncommon but concerning condition for h ospitalized premature infants. A retrospective chart review of all male inf ants admitted to the neonatal intensive care unit (NICU) from June 1996 thr ough March 1999 was conducted at the Medical College of Georgia-a large aca demic medical center with a tertiary Level III NICU-to investigate the freq uency and potential prevention of recurrent UTI in hospitalized infants. Th e effect of circumcision on recurrence of UTI was also in investigated. The re were 38 infants with 53 UTIs among 744 male infants admitted during the study period (5.1%), Infants were divided into two groups: A1 <37 weeks wit h a single UTI and A2 <37 weeks with more than one UTI, In groups Al and A2 , 57% of the fir-st UTIs were due to Candida or E, coli, the remaining were due to other gram-negative organisms and Staphylococcus species. Mean gest ational age (GA) in groups Al and A2 were similar (29 +/- 2 weeks, and 29 /- 4 weeks); however, mean GA of infants with Candida UTI was 27 +/- 2 week s, and for bacterial UTI, 30 +/- 3 weeks (p<0.01). None of the premature in fants in the study had a recurrent UTI once a circumcision was performed, P remature uncircumcised males had an increased risk for UTI (Odds Ratio=11.1 , 95% CI, 3.3-28.9, p<0.001). Circumcision appears beneficial in reducing t he risk for recurrent UTI in these infants.