How to know if your child has a uti

Urinary Tract Infections (UTIs) (for Parents)

Urinary tract infections (UTIs) are common in kids. They happen when bacteria (germs) get into the bladder or kidneys.

A baby with a UTI may have a fever, throw up, or be fussy. Older kids may have a fever, have pain when peeing, need to pee a lot, or have lower belly pain.

Kids with UTIs need to see a doctor. These infections won't get better on their own. UTIs are easy to treat and usually clear up in a week or so.

Taking antibiotics kills the germs and helps kids get well again. To be sure antibiotics work, you must give all the prescribed doses — even when your child starts feeling better.

What Are the Signs & Symptoms of a UTI?

Most UTIs happen in the lower part of the urinary tract — the urethra and bladder. This type of UTI is called cystitis. A child with cystitis may have:

pain, burning, or a stinging sensation when peeing
an increased urge or more frequent need to pee (though only a very small amount of pee may be passed)
fever
waking up at night a lot to go to the bathroom
wetting problems, even though the child is potty trained
belly pain in the area of the bladder (generally below the belly button)
foul-smelling pee that may look cloudy or contain blood

An infection that travels up the ureters to the kidneys is called pyelonephritis (pie-low-nih-FRY-tis) and is usually more serious. It causes many of these same symptoms, but the child often looks sicker and is more likely to have a fever (sometimes with shaking chills), pain in the side or back, severe tiredness, or vomiting.

What Causes UTIs?

UTIs are much more common in girls because a girl's urethra is shorter and closer to the anus (where poop comes out). Uncircumcised boys younger than 1 year also have a slightly higher risk for a UTI.

Other risk factors for a UTI include:

a problem in the urinary tract (for example, a malformed kidney or a blockage somewhere along the tract of normal urine flow)
an abnormal backward flow (reflux) of urine from the bladder up the ureters and toward the kidneys. This is known as vesicoureteral reflux (VUR), and many kids with a UTI are found to have it.
poor toilet and hygiene habits
family history of UTIs

UTIs are easy to treat, but it's important to catch them early. Undiagnosed or untreated UTIs can lead to kidney damage.

How Are UTIs Diagnosed?

To diagnose a UTI, health care providers ask questions about what's going on, do an exam, and take a sample of pee for testing.

How a sample is taken depends on a child's age. Older kids might simply need to pee into a sterile cup. For younger children in diapers, a catheter is usually preferred. This is when a thin tube is inserted into the urethra up to the bladder to get a "clean" urine sample.

The sample may be used for a urinalysis (a test that microscopically checks the urine for germs or pus) or a urine culture (which attempts to grow and identify bacteria in a laboratory). Knowing what bacteria are causing the infection can help your doctor choose the best treatment.

How Are UTIs Treated?

UTIs are treated with antibiotics. After several days of antibiotics, your doctor may repeat the urine tests to be sure that the infection is gone. It's important to make sure of this because an incompletely treated UTI can come back or spread.

If a child has severe pain when peeing, the doctor may also prescribe medicine that numbs the lining of the urinary tract. (This medicine temporarily causes the pee to turn orange.)

Give prescribed antibiotics on schedule for as many days as your doctor directs. Keep track of your child's trips to the bathroom, and ask your child about symptoms like pain or burning during peeing. These symptoms should improve within 2 to 3 days after antibiotics are started.

Encourage your child to drink plenty of fluids, but skip drinks that containe caffeine (which can irritate the bladder), such as soda and iced tea.

Most UTIs are cured within a week with treatment.

Treatment for More Severe UTIs

Kids with a more severe infection may need treatment in a hospital so they can get antibiotics by injection or IV (intravenously, given into a vein right into the bloodstream).

This might happen if:

the child has high fever or looks very ill, or a kidney infection is likely
the child is younger than 6 months old
bacteria from the infected urinary tract may have spread to the blood
the child is dehydrated or is vomiting and cannot take any fluids or medicine by mouth

Kids with VUR will be watched closely by the doctor. VUR might be treated with medicines or, less commonly, surgery. Most kids outgrow mild forms of VUR, but some can develop kidney damage or kidney failure later in life.

Can UTIs Be Prevented?

These tips can help prevent UTIs:

In infants and toddlers, change diapers often to help prevent the spread of bacteria that cause UTIs. When kids are potty trained, it's important to teach them good hygiene. Girls should know to wipe from front to rear — not rear to front — to prevent germs from spreading from the anus to the urethra.
School-age girls should avoid bubble baths and strong soaps that might cause irritation. They also should wear cotton underwear instead of nylon because it's less likely to encourage bacterial growth.
All kids should be taught not to "hold it" when they have to go. Pee that stays in the bladder gives bacteria a good place to grow.
Kids should drink plenty of fluids but avoid those with caffeine.

When Should I Call the Doctor?

Call the doctor right away if your child has an unexplained fever with shaking chills, especially if there's also back pain or any type of pain when peeing.

Also call if your child has any of these:

bad-smelling, bloody, or discolored pee
low back pain or belly pain (especially below the belly button)
a fever of over 101°F (38.3°C) in children or 100.4°F (38°C) rectally in infants

Call the doctor if your infant has a fever, feeds poorly, vomits repeatedly, or seems unusually irritable.

Symptoms, Causes, Treatment, & Diagnosis

Written by WebMD Editorial Contributors

How Do Kids Get UTIs?

It happens when bacteria from their skin or poop get into the urinary tract and multiply. These nasty germs can cause infections anywhere in the urinary tract, which is made up of the:

Kidneys, which filter wastes and extra water out of the blood to make urine
Ureters, which send urine from the kidneys into the bladder
Bladder, which stores urine
Urethra, which empties urine from the bladder out of the body

A bladder infection is called cystitis. A kidney infection is called pyelonephritis.

Girls are more likely to get UTIs than boys are because their urethra is shorter. Bacteria from the anus can more easily get into the vagina and urethra.

Some kids have a problem with their bladder or kidneys that makes them more likely to get UTIs. Narrowing in the urinary tract can block urine flow and allow germs to multiply. A condition called vesicoureteral reflux (VUR) can cause urine to back up from the bladder into the ureters and kidneys.

What Are the Signs and Symptoms?

In older kids, the symptoms are often clear. The main symptoms are pain in the lower belly, back, or side and an urgent need to pee or pee more often. Some kids who already have been toilet trained lose control over their bladder, and may wet the bed. You may even see drops of blood in the urine, and/or the urine is pink.

With younger children, you might need to do a little digging to find out what's wrong. Infants can have more general symptoms, like fussiness, little interest in food, or a fever.

Other symptoms of a UTI include:

Burning or pain when your child pees
Foul-smelling or cloudy pee
An urgent need to go, and then only peeing a few drops
Fever
Nausea or vomiting
Diarrhea

How Is It Diagnosed?

If your child has symptoms of a UTI, see your pediatrician. The doctor will take a urine sample and test it for bacteria. They can collect urine in a number of ways:

Older children can pee into a cup (doctors call this a “clean catch”).
Younger children who aren't toilet trained will have a plastic bag placed over their genitals to collect the urine.
Children who wear diapers can have a tube (catheter) inserted into their urethra and bladder to collect the sample.
In infants, the doctor can place a needle straight into the bladder through the stomach to get the sample.

At the lab, a technician looks at the sample under a microscope to see whether germs are in the urine. It might also be cultured -- that means the lab tech places the urine in a dish to see what type of bacteria grow in it. This can help your doctor find the exact germs that caused your child’s UTI so they’ll know the right type of medicine to prescribe to kill them.

If your child has had a few UTIs, your doctor might refer you to a nephrologist (kidney specialist) and do one or more of these imaging tests to look for problems in the urinary tract:

Ultrasound uses sound waves to show any blockages or other problems in the kidneys
Voiding cystourethrogram (VCUG) places fluid into the bladder through a tube to show any problems in the urethra or bladder when your child pees
Nuclear scan uses liquids that contain a small amount of radioactive material to see how well the kidneys work
CT, or computed tomography, is a powerful X-ray that makes detailed pictures of the bladder and kidneys
MRI, or magnetic resonance imaging, uses powerful magnets and radio waves to make pictures of the bladder and kidneys

What Are the Treatments for UTIs?

Antibiotics, mainly. These medications kill bacteria. Kids usually take them for anywhere from 3 to 10 days (most commonly 7-10 days). Your doctor might do another urine test after your child finishes the medicine to see if the infection has cleared up.

Make sure your child finishes all of their meds, even if they start to feel better. Stopping too soon can make germs resistant to antibiotics and cause another infection.

Most UTIs clear up in about a week. Some kids will have symptoms for a few weeks. Call your doctor if your child's symptoms don't start to improve after 3 days from when they started on antibiotics, or if they get worse.

How Can You Prevent UTIs in the Future?

Change your baby's diapers often to prevent bacteria from growing. As your child gets older, teach them good bathroom habits to prevent UTIs. Instruct girls to wipe from front to back. This helps to prevent bacteria in poop from getting into the vagina and urinary tract. Encourage your kids to go to the bathroom as soon as they feel the urge -- not to hold it in.

Girls should avoid bubble baths and should not use perfumed soaps. And, they should wear cotton underwear -- not nylon -- to improve airflow and prevent bacteria from growing.

Have your kids drink lots of water, which helps flush bacteria out of the urinary tract. Extra water also prevents constipation, which can create blockages in the urinary tract that allow bacteria to grow.

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. nine0003

Most often this pathology is caused by microbes such as:

- Escherichia coli,

- Staphylococcus aureus,

- Pseudomonas aeruginosa,

- Klebsiella

These include:

- 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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

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. nine0003

- 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. nine0003

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.

Urinary tract infection in children. What is urinary tract infection in children?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor. nine0003

Urinary tract infection in children is a group of microbial-inflammatory diseases of the urinary system organs: kidneys, ureters, bladder, urethra. Depending on the location of the inflammation, urinary tract infection in children can be manifested by dysuric disorders, pain in the bladder or lower back, leukocyturia and bacteriuria, and temperature reaction. Examination of children with suspected urinary tract infection includes urinalysis (general, bacterial culture), ultrasound of the urinary system, cystoureterography, excretory urography, cystoscopy. The basis for the treatment of urinary tract infections in children is the appointment of antimicrobial drugs, uroantiseptics. nine0003

Causes of urinary tract infection in children
Classification
Symptoms in children
Diagnostics
Treatment of urinary tract infection in children
Prognosis and prevention
Prices for treatment

General

Urinary tract infection in children is a general concept that refers to inflammatory processes in various parts of the urinary tract: infections of the upper urinary tract (pyelitis, pyelonephritis, ureteritis) and lower urinary tract (cystitis, urethritis). Urinary tract infections are extremely common in childhood - by age 5, 1-2% of boys and 8% of girls have had at least one episode of the disease. The prevalence of urinary tract infections depends on age and gender: for example, among newborns and infants, boys are more likely to get sick, and girls between the ages of 2 and 15 years. Most often in the practice of pediatric urology and pediatrics one has to deal with cystitis, pyelonephritis and asymptomatic bacteriuria. nine0003

urinary tract infection in children

Causes of urinary tract infection in children

The spectrum of microbial flora that causes urinary tract infections in children depends on the sex and age of the child, the conditions of infection, the state of intestinal microbiocenosis and general immunity. In general, among bacterial pathogens, enterobacteria are in the lead, primarily E. coli (50-90%). In other cases, Klebsiella, Proteus, Enterococci, Pseudomonas aeruginosa, Staphylococci, Streptococci, etc. are sown. Acute urinary tract infections in children are usually caused by one type of microorganism, however, with frequent relapses and malformations of the urinary system, microbial associations are often detected. nine0003

Urinary tract infections in children can be associated with urogenital chlamydia, mycoplasmosis and ureaplasmosis and combined with vulvitis, vulvovaginitis, balanoposthitis. Fungal infections of the urinary tract often occur in debilitated children: premature, suffering from malnutrition, immunodeficiency states, anemia. There is an assumption that a viral infection (infection with Coxsackie, influenza, adenoviruses, herpes simplex virus types I and II, cytomegalovirus) is a factor contributing to the layering of a bacterial infection. nine0003

Conditions accompanied by impaired urodynamics predispose to the development of urinary tract infection in children: neurogenic bladder, urolithiasis, bladder diverticula, vesicoureteral reflux, pyelectasis, hydronephrosis, polycystic kidney disease, kidney dystopia, ureterocele, phimosis in boys, synechia of the labia in girls. Often, urinary tract infections in children develop against the background of gastrointestinal diseases - dysbacteriosis, constipation, colitis, intestinal infections, etc. Metabolic disorders (dysmetabolic nephropathy in children, glucosuria, etc.) can be a risk factor. nine0003

The introduction of infection into the urinary tract can occur with insufficient hygiene of the external genitalia, improper washing technique of the child, lymphogenous and hematogenous routes, during medical manipulations (bladder catheterization). Boys who have undergone circumcision suffer from urinary tract infections 4-10 times less often than uncircumcised boys.

Classification

According to the localization of the inflammatory process, infections of the upper urinary tract are distinguished - the kidneys (pyelonephritis, pyelitis), ureters (ureteritis) and the lower sections - the bladder (cystitis) and urethra (urethritis). nine0003

According to the period of the disease, urinary tract infections in children are divided into the first episode (debut) and relapse. The course of recurrent urinary tract infection in children may be maintained by unresolved infection, persistence of the pathogen, or reinfection.

According to the severity of clinical symptoms, mild and severe urinary tract infections in children are distinguished. In a mild course, the temperature reaction is moderate, dehydration is insignificant, the child complies with the treatment regimen. Severe urinary tract infection in children is accompanied by high fever, persistent vomiting, severe dehydration, sepsis. nine0003

Symptoms in children

Clinical manifestations of urinary tract infection in a child depend on the localization of the microbial-inflammatory process, the period and severity of the disease. Consider the signs of the most common urinary tract infections in children - pyelonephritis, cystitis and asymptomatic bacteriuria.

Pyelonephritis in children occurs with febrile temperature (38-38. 5 ° C), chills, symptoms of intoxication (lethargy, pallor of the skin, loss of appetite, headache). At the height of intoxication, frequent regurgitation, vomiting, diarrhea, neurotoxicosis, and meningeal symptoms may develop. The child is concerned about pain in the lumbar region or abdomen; effervescence symptom is positive. At an early age, infections of the upper urinary tract in children can be hidden under the guise of pylorospasm, dyspeptic disorders, acute abdomen, intestinal syndrome, etc.; in older children - flu-like syndrome. nine0003

Cystitis in children is manifested primarily by dysuric disorders - frequent and painful urination in small portions. In this case, complete simultaneous emptying of the bladder is not achieved, episodes of urinary incontinence are possible. In infants, cystitis is often accompanied by stranguria (urinary retention). The presence of dysuria in children of the first year of life can be indicated by anxiety or crying associated with urination, intermittent and weak urine stream. Cystitis is characterized by pain and tension in the suprapubic region; the temperature in cystitis is normal or subfebrile. nine0003

Asymptomatic bacteriuria is more common in girls. This form of urinary tract infection in children is not accompanied by any subjective clinical signs, but is detected only during laboratory examination. Sometimes parents pay attention to the turbidity of the child's urine and the bad smell emanating from it.

Diagnosis

Assessment of the severity of urinary tract infections in children requires an integrated approach and the participation of a number of specialists - a pediatrician, pediatric urologist, pediatric nephrologist, pediatric gynecologist. nine0003

Urinary tract infections in children may be suspected if leukocyturia, bacteriuria, proteinuria, and sometimes hematuria are detected in a general urine test. For a more detailed diagnosis, a urine test according to Nechiporenko, Zimnitsky's test is shown. Blood changes are characterized by neutrophilic leukocytosis, elevated ESR; with pyelonephritis - a high level of acute phase proteins (CRP, alpha globulins).

The basis for the diagnosis of urinary tract infections in children is a bacteriological culture of urine with the release of the pathogen, an assessment of the degree of bacteriuria and sensitivity to antibiotics. In some cases, a urine test for chlamydia, ureaplasma, mycoplasma is required by cultural, cytological, serological (ELISA) methods, PCR. nine0003

Children with a urinary tract infection must undergo an ultrasound examination of the urinary system (ultrasound of the kidneys, ultrasound of the vessels of the kidneys, ultrasound of the bladder). X-ray contrast studies of the urinary tract (excretory urography, voiding cystography, urethrography) are indicated only for repeated episodes of urinary tract infections in children and only in the remission phase. To study the state of the renal parenchyma, static or dynamic scintigraphy of the kidneys is performed.

Endoscopy methods in children (ureteroscopy, cystoscopy) are used to detect urethritis, cystitis, anomalies of the urethra and bladder. In order to study urodynamics, uroflowmetry and cystometry are performed.

Treatment of urinary tract infection in children

The main place in the treatment of urinary tract infections in children belongs to antibiotic therapy. Until a bacteriological diagnosis is established, initial antibiotic therapy is given on an empirical basis. Currently, in the treatment of urinary tract infections in children, preference is given to inhibitor-protected penicillins (amoxicillin), aminoglycosides (amikacin), cephalosporins (cefotaxime, ceftriaxone), carbapenems (meropenem, imipenem), uroantiseptics (nitrofurantoin, furazidin). The duration of the course of antimicrobial therapy should be 7-14 days. After completion of the course of treatment, a repeated laboratory examination of the child is carried out. nine0003

It is recommended to take NSAIDs (ibuprofen), desensitizing agents (clemastine, loratadine), antioxidants (vitamin E, etc.), herbal medicine. Asymptomatic bacteriuria usually does not require treatment; sometimes uroseptics are prescribed in these cases.

When an acute urinary tract infection subsides, children are shown physiotherapy: microwave, UHF, electrophoresis, paraffin and ozocerite applications, mud therapy, pine baths.

Prognosis and prevention

Advanced urinary tract infections in children can lead to irreversible damage to the renal parenchyma, kidney shrinkage, hypertension, and sepsis. Recurrences of urinary tract infections occur in 15-30% of cases, so children at risk are given anti-relapse prophylaxis with antibiotics or uroantiseptics. The child should be under the supervision of a pediatrician and a nephrologist. Vaccination of children is carried out during periods of clinical and laboratory remission.