Is a VCUG required after every neonatal UTI?

A retrospective three-center study of 126 NICU infants diagnosed with urinary tract infection (UTI) found that 60% of infants that underwent renal ultrasonography had abnormal renal ultrasound findings (hydronephrosis or pelvicaliectasis), with 12% having severe abnormalities. Vesico ureteric reflux (VUR) was found in 4% of infants who underwent a voiding cystourethrogram (VCUG). No infant had severe VUR. A routine VCUG after UTI in the NICU had a low yield and may be reserved for infants with severe or persistent abnormalities on renal ultrasonography.

 

Do infants in the neonatal intensive care unit diagnosed with urinary tract infection need a routine voiding cystourethrogram? Flannery et al, 2017