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Urinary Tract Infections (UTIs) in Infants & Children
What Are Urinary Tract Infections (UTIs)?
A urinary tract infection (UTI) happens when bacteria (germs) gets into the urinary tract. The most common place for a UTI to occur is in the bladder, but infections also occur in the urethra, ureters or kidneys. UTIs are easily treated but can cause problems if left alone.
What is the urinary tract and how do infections occur?
The urinary tract is the body’s drainage system for getting rid of urine (liquid waste). It includes the two kidneys, bladder (the organ where urine is stored), and two ureters and one urethra (tubes).
The blood in the body passes through the kidneys. The kidneys filter the liquid waste products (urine) out of the blood. This urine passes through the ureters and into the bladder. The urine leaves the bladder through the urethra, and passes out of the body through the opening (meatus).
Most UTIs in children occur because bacteria that are normally found in the bowel cause an infection in the urinary tract.
What causes UTIs?
These factors can increase your child’s chance of getting a UTI:
Poor bathroom habits, such as not changing out of wet underwear or not wiping properly
“Holding it,” instead of urinating frequently (in toilet trained kids)
Frequent constipation or diarrhea
Having some kind of blockage in the urinary tract that limits or stops urine flow
Irritation in the “perineal” area (where urine comes out of the body). This can be caused by things such as bubble bath, bath soap or tight clothing.
A condition called vesicoureteral reflux (VUR), in which urine flows backward from the bladder and toward the kidneys
Learn about how to prevent a UTI.
Are UTIs common in children?
UTIs are the second most common type of infection in children (ear infections are the most common). They are more common in girls, although uncircumcised boys are at slightly higher risk than other male babies or older boys.
What are the signs and symptoms of a UTI?
There are two different kinds of UTIs. The most common is called cystitis. It occurs when the infection is in the urethra or bladder. A child who has cystitis may:
Have a fever (this may be the only symptom in babies)
Be fussy (common in babies)
Vomit (common in babies or older children)
Feel the need to use the bathroom often, yet only pass a very small amount of urine (more common in older children)
Wet themselves, even after being successfully potty trained
Have pain or burning with urination (more common in older children)
Have lower belly or back pain
Have blood in the urine
The less common type of UTI is called pyelonephritis, which is an infection that occurs in the kidneys. Pyelonephritis can sometimes be treated at home, but in some cases it can become serious and even life threatening. A child who has pyelonephritis may have:
A fever greater than 101 degrees
Flu-like symptoms such as shaking, chills, nausea, vomiting or achiness
Pain in the belly, back, side or groin
Pain or a burning feeling when urinating
Urine that is cloudy, red, foul smelling or changes to a dark cola color
Pus or blood in the urine
Urgent or frequent urination
If your child experiences symptoms of cystitis or pyelonephritis, call your pediatrician.
How is a child diagnosed with a UTI?
If the pediatrician thinks your child may have a UTI, they will:
Ask about your child’s symptoms and health history
Do a physical exam
Run tests, including a urinalysis (a simple study of a urine sample) and/or urine culture (which detects specific bacteria in urine)
How do you treat UTIs?
The most common treatment for a UTI is antibiotics, which kill the germs that are causing the infection. The pediatrician also may recommend that your child take pain relief medicine as needed, and drink plenty of fluids.
UTIs can cause irritation and raw skin on your child’s private parts. If these symptoms do not improve after exposing the skin to air and creating a moisture barrier with petroleum jelly or, zinc oxide or lanolin, let your pediatrician know.
If my child is being treated for a UTI, what can I do to help?
Give your child all the medicine the doctor prescribed for the infection. Do not stop the medicine, even if your child is feeling and acting better.
Give your child lots of fluids to drink so they continue to urinate regularly, every two to three hours for toilet trained children.
Tell your doctor if your child’s fever, pain or other symptoms continue after taking the medicine for two days.
If your child is in pain or has a fever, give medicine only as directed by the doctor. Do not give aspirin to children.
Keep all follow-up appointments.
Do not allow your child to sit in bathwater that contains bubble bath, shampoo or soap, as this can cause irritation. If your child takes a bath, have them sit in clear water until you’re ready to use these products. Once you are finished, rinse your child off and remove the products from the tub.
What if my child gets frequent UTIs?
Some children get UTIs more often than others. Be sure to tell your pediatrician if symptoms happen again after treatment, or if your child has three or more UTIs in a six-month period.
The pediatrician may recommend taking your child to a pediatric urology practice for an evaluation. Physicians and nurse practitioners at this type of practice specialize in treating children who have problems with their urinary system. These specialists may run additional tests to learn about the cause, and recommend a new treatment plan.
These additional tests may include:
An ultrasound to view the kidneys, bladder and the tubes connecting them
A voiding cystourethrogram (sis-toe-u-reeth-ro-gram), or VCUG. This X-ray shows how the bladder is working while the person is urinating.
Last Updated 07/2021
Reviewed By Nicole Inman, CNP
The Division of Urology treats a complete range of disorders affecting the urinary and genital tracts, from common concerns to rare and complex abnormalities.
For more information or to request an appointment, contact the Division of Urology.
Urinary tract infection in newborns.
Urinary tract infection in young children is no less common than viral respiratory infections. Vomiting and nausea, cramps in the abdomen are often attributed by parents to colic, malnutrition or intestinal infections. However, with such symptoms, it is recommended to consult a doctor. If this is a urinary tract infection, then its untimely diagnosis and treatment will lead to unpleasant consequences for the baby.
A urinary tract infection occurs when bacteria in the child's body begin to multiply rapidly in the urinary tract.
Most often this pathology is caused by microbes such as:
- Escherichia coli,
- Staphylococcus aureus,
- Pseudomonas aeruginosa,
- vesicoureteral reflux;
- narrowing of the ureters;
- malposition of the organs of the urinary system;
- horseshoe kidney and others
Another cause of infection is the presence of a microbial focus in the body. With an infectious-inflammatory pathology of other organs, the bacterial flora can enter the kidneys and urinary tract, causing inflammation there. Also, the bacterium can enter the baby's body from the mother during breastfeeding.
Genitourinary infection in infants presents with the same symptoms as in adults. The problem is that a newborn baby cannot complain.
Parents should keep a close eye on their child to detect symptoms of illness.
Initial symptoms include tearfulness, restlessness, poor sleep and loss of appetite.
In children under one year old, a urinary tract infection may be manifested by a decrease or increase from the age norm of urine excreted, a change in the color and saturation of urine (the child's urine may become bright yellow (with an increase in the concentration of urine, which is usually accompanied by a decrease in its quantity), red or brown (admixture of blood.) When bacteria appear, the urine does not change its color, but becomes cloudy and loses its transparency.0003
Edema may appear due to the characteristics of the baby's body, the appearance of an unpleasant smell from the diaper.
The appearance of restlessness and crying when urinating, which indicates the presence of pain and cramps in the baby. Often, mothers note that the child strains when urinating. In this case, an intermittent stream of urine is recorded.
The rise in temperature to high numbers, if it does not go away after taking antipyretics and persists for several days, this is a reason to suspect an infection.
Infection of the genitourinary system in infants is detected by laboratory analysis of urine, urine culture, blood test, b / x blood test.
In case of inflammation, blood and urine tests show an increase in the number of leukocytes. With bakposev, it is possible to identify which bacterium caused the infection, and determine the individual sensitivity of the microbe to the antibiotic.
As noted above, the cause of infection in infants may be a congenital malformation of the genitourinary organs.
If this pathology is suspected, the following examinations should be performed:
- ultrasound examination of the urinary system organs;
- voiding cystography;
- retrograde radiography of the kidneys;
- CT or MRI of the kidneys.
The basis for the treatment of urinary tract infection is antibiotic therapy. A broad-spectrum antibiotic or a drug based on sensitivity is prescribed. The antibiotic is taken orally or injected intravenously.
It is important that if an infection is detected, the infant must be hospitalized for the duration of treatment. In addition to antibiotics, anti-inflammatory drugs and antipyretics are used. Moreover, many medicines are produced in a convenient form of application, for example, in candles.
Herbal uroseptics are often prescribed, which do not have a toxic effect and contribute to the recovery of the child. In no case should you start treatment on your own or cancel medications without a doctor's prescription. This will lead to the fact that the disease will go into a latent stage and will periodically worsen, again and again causing unpleasant symptoms. In addition, many drugs are contraindicated for children and their uncontrolled use will bring irreparable harm to the child.
Infection in infants with malformations will constantly recur despite good treatment. Therefore, the only way out is to carry out an operational correction of the defect. It should be noted that the operation is possible only after the acute inflammatory process is eliminated.
Prevention of urinary tract infections in infants.
In order to rule out an illness in a child, the following points should be followed:
- Carefully monitor the hygiene of the child's urinary organs.
- avoid hypothermia of the baby;
- monitor the rationality of nutrition.
Every year about 1400 children are treated in the Department of Prematurity and Pathology of Newborns. Of these, with urinary tract infection 65-70, with various congenital malformations of the kidneys and urinary system 28-30 children. All children undergo a complex of examinations and treatment according to the developed standards. All children are discharged with improvement and recovery and are subsequently observed by nephrologists and urologists in the regional children's clinic.
Infection of the genitourinary system is not such a terrible diagnosis. With a complete examination and high-quality, adequately selected therapy, the child will recover without any residual effects.
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