PEDIATRIC UTI

Urinary tract infections are infections in any part of the urinary tract. They happen when bacteria get into the bladder or kidneys. When it involves the lower tract, it is termed CYSTITIS. Infection in the upper portion, or in the kidney parenchyma is termed PYELONEPHRITIS.

Bacteria or germs are the most common cause of UTI in kids. Most of the time, bacteria like E. coli, normally found in the bowel, are the culprit. Risk factors for developing UTI include poor hygienic practices; withholding of urine; not drinking enough water; and chronic constipation. Sometimes, congenital defects or anatomic defects like double collecting system, myelomeningocoele or Vesico-ureteral reflux may also predispose the child to recurrent UTI.

A clean catch, midstream urine specimen will be needed for urinalysis. In some instances, a urine culture may be necessary. A urine culture will identify what type of bacteria is causing the UTI and the sensitivity testing will tell which antibiotics would be able to eliminate the organism.

UTI is treated with antibiotic. However, you must NOT take antibiotics on your own. You must visit your doctor so he/she can prescribe the correct antibiotic and at the correct dose. Not all antibiotics are created equal. You must also complete the number of days prescribed by your Doctor.

FEVER

Fever is a very common symptom, however, UTI may also occur in the absence of fever.

DYSURIA

Painful urination is more common in cystitis.

VOMITTING/ DIARRHEA

In very young infants and small children, UTI may present as vomiting and/or diarrhea

HEMATURIA

Blood in the urine may be found especially in cystitis

UTI is prevented by practicing proper hygiene; drinking lots of water; eating a balanced, healthy diet; not withholding urine; addressing constipation.

References:

1. Nelson’s Textbook of pediatrics 21^st edition
2. Avner, et.al., Pediatric Nephrology, 2016
3. PNSP Consensus on Urinary Tract Infection, 2018