What cause urine infection in babies
Urinary Tract Infections In Babies
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Symptoms & Causes of Bladder Infection in Children
What are the symptoms of a bladder infection?
Don’t assume that you’ll know when your child has a bladder infection, even if you’ve had one yourself.
Symptoms can be very different in children than in adults, especially for infants and preschoolers. If your child is not well, contact your child’s pediatrician or health clinic.
Young children
It’s not always obvious when an infant or child younger than age 2 has a bladder infection. Sometimes there are no symptoms. Or, your child may be too young to be able to explain what feels wrong. A urine test is the only way to know for certain whether your child has a bladder or kidney infection.
When a young child has symptoms of a UTI, they may include
- fever, which may be the only sign
- vomiting or diarrhea
- irritability or fussiness
- poor feeding or appetite; poor weight gain
Older children
Symptoms of a bladder or kidney infection in a child ages 2 and older can include
- pain or burning when urinating
- cloudy, dark, bloody, or foul-smelling urine
- frequent or intense urges to urinate
- pain in the lower belly area or back
- fever
- wetting after a child has been toilet trained
Seek care right away
If you think your child has a bladder infection, take him or her to a health care professional within 24 hours.
A child who has a high fever and is sick for more than a day without a runny nose, earache, or other obvious cause should also be checked for a bladder infection. Quick treatment is important to prevent the infection from getting more dangerous.
What causes a bladder infection?
Most often a bladder infection is caused by bacteria that are normally found in the bowel. The bladder has several systems to prevent infection. For example, urinating most often flushes out bacteria before it reaches the bladder. Sometimes, your child’s body can’t fight the bacteria and the bacteria cause an infection. Certain health conditions can put children at risk for bladder infections.
Last Reviewed April 2017
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health.
The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Saul P. Greenfield, MD, FAAP, FACS, State University of New York at Buffalo School of Medicine; Jeffrey M. Saland, MD, MSCR, Icahn School of Medicine at Mt. Sinai
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,
- 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.
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.
Urinary tract infections (UTIs) in children
According to statistics, urinary tract infections (UTIs) rank second after acute respiratory infections. Children under 3 years of age are especially susceptible to them. Moreover, in almost half of the cases, the inflammatory process starts asymptomatically, which is why parents do not have the opportunity to see a doctor in time. How to suspect an infection in a timely manner? How to prevent the development of complications? And how to treat the disease?
Definition
- Urinary tract infection (UTI) is a group of inflammatory diseases of the urinary system that develop when an infectious agent enters the body.
- Bacteriuria is the presence of bacteria in urine from the bladder. Asymptomatic bacteriuria is called, detected during a dispensary or targeted examination in a child without any complaints and clinical symptoms of a disease of the urinary system.
- Acute pyelonephritis is an inflammatory disease of the kidney caused by a bacterial infection.
- Acute cystitis is an inflammatory disease of the bladder of bacterial origin.
- Chronic pyelonephritis - kidney damage, manifested by fibrosis and deformity of the pelvicalyceal system, as a result of repeated attacks of UTI infection. As a rule, it occurs against the background of anatomical anomalies of the urinary tract or obstruction.
- Vesicoureteral reflux (VUR) is a retrograde flow of urine from the bladder into the ureter.
- Reflux nephropathy - focal or diffuse sclerosis of the renal parenchyma, the primary cause of which is vesicoureteral reflux, leading to intrarenal reflux, repeated attacks of pyelonephritis and sclerosis of the renal tissue.
- Urosepsis is a generalized nonspecific infectious disease that develops as a result of the penetration of various microorganisms and their toxins from the organs of the urinary system into the bloodstream.
Prevalence
In infants and young children, UTI is the most common severe bacterial infection, occurring in 10–15% of hospitalized febrile patients of this age. Before the age of 3 months, UTI is more common in boys, at an older age - in girls. At primary school age - in 7.8% of girls and 1.6% of boys. With age after the first episode of UTI, the relative risk of recurrence increases.
Recurrence rate:
in girls:
- 30% within one year of the first episode;
- 50% within 5 years of first episode;
in boys:
- 15–20% within one year of the first episode.
Some important facts about the disease
Most urinary tract infections in children are caused by bacteria such as E. coli, Enterococcus, Proteus and Klebsiella.
Among the numerous factors that cause the development of infection, the biological properties of microorganisms that colonize the urinary tract, and urodynamic disorders (vesicoureteral reflux, urinary tract obstruction, neurogenic bladder dysfunction) are of priority importance.
The most common route of infection is ascending. The reservoir of uropathogenic bacteria is the rectum, perineum, lower urinary tract.
The anatomical features of the female urinary tract (short wide urethra, proximity to the anorectal region) cause a high incidence and recurrence of urinary tract infections in girls and girls.
Diagnosis
In adults, urinary tract infections are usually accompanied by unpleasant symptoms (frequent and painful urination, acute pain in the lower abdomen, etc.), but in the case of children, all these signs of an inflammatory process UTIs are often absent, except for high fever. In fact, the fever itself in a child in the absence of any other visible symptoms of the disease often signals precisely the onset of inflammation in the urinary tract (in this case, a general analysis of the child's urine should be performed).
There are situations when a urinary tract infection in children manifests itself in the following signs:
- Child complains of soreness or burning sensation during "going to the toilet";
- The child complains of pain in the lower abdomen;
- Urine takes on an uncharacteristic color, density, or odor;
- Urinary incontinence (especially at night) over 7-8 years of age;
- Constant thirst;
- The general condition and behavior of the child may change - the baby becomes lethargic, capricious, whiny, loses appetite, etc.
A urinalysis can be used to refute or confirm the presence of a UTI with these symptoms. As a diagnostic method, it is recommended to conduct a clinical analysis of urine with a count of the number of leukocytes, erythrocytes and the determination of nitrates.
Since the diagnosis of a suspected urinary tract infection is based on the result of a child's urine test, it is very important to collect the material for this analysis correctly and submit it on time. To collect tests, you need to use special sterile containers that are sold in a pharmacy. To collect urine from newborns and infants, convenient devices have been invented - special urinals that save parents from having to “squeeze out” diapers or guard near the baby, spread out on oilcloth ... These devices are completely safe, they are hermetically glued to the child’s genitals, do not cause the baby has no discomfort and is simply removed. No more than 1.5 hours should elapse between the moment of urine collection and its entry into the laboratory.
In other words, you can not collect urine from a child before bedtime, then put it in the refrigerator, and in the morning take such material to the laboratory - this analysis will not be reliable.
To avoid problems with urine collection, refuse to use special devices for collecting urine, a portable urine analyzer allows you to “wet” the test strip both directly in the urine stream and in any place where the child has urinated.
There are situations when it is difficult to quickly pass a urine test (late time of day, remoteness of the laboratory, etc.). In these cases, having a portable urine analyzer at home can be indispensable.
The diagnosis of UTI is not made without confirmation by laboratory tests of urine (general analysis of urine for an infectious process in the urinary tract indicates an abnormally large number of leukocytes). Sometimes a child is also assigned an ultrasound or x-ray study of the structural features of the urinary system, a consultation with a pediatric gynecologist or andrologist.
Treatment
If the diagnosis of UTI is confirmed, the doctor prescribes antibiotic therapy. The basis of effective treatment of any urinary tract infection in children and adults is the use of age-appropriate and medical situation-appropriate antibiotics. Already after 24-48 hours after the start of taking the drugs, the child's well-being will noticeably improve, but it is important for parents to remember that for a true recovery it is necessary to endure a full course of antibiotic therapy, which averages 7-14 days.
Indications for hospitalization in a specialized hospital for children with urinary tract infection:
- Young children (less than 2 years old).
- Presence of symptoms of intoxication.
- Inability to perform oral rehydration if there are signs of dehydration.
- Bacteremia and sepsis.
- Recurrent course of UTI to exclude its secondary nature and selection of adequate anti-relapse treatment.
The length of stay in the hospital for a UTI is 10-14 days.
Given the young age of many patients, the inability to find out the child's complaints, the absence of specific symptoms, in some cases it is difficult for parents to decide what caused the child's body temperature to rise - teething, banal SARS or urinary infection requiring hospitalization in a hospital. An express urinalysis can help in solving such a difficult issue. In these cases, the presence of a portable urine analyzer at home can become indispensable, with the help of the device you can quickly send the results of the analysis to your pediatrician, and the doctor will help you understand the difficult situation and make the right decision.
Prevention
- Regular bladder and bowel movements.
- Adequate fluid intake.
- Hygiene of the external genital organs.
Indications for preventive treatment:
- presence of vesicoureteral reflux grade 2-5;
- recurrence of UTI infection;
- severe anomalies in the development of UTI before surgical correction.
The duration of prophylaxis is selected individually: usually at least 6 months.
It is convenient to track the need for initiation of prophylactic treatment and its effectiveness by monitoring a complete urinalysis. In these cases, a portable urine analyzer is indispensable.
Case management and rehabilitation
- If UTIs recur (more than 2 in girls, more than 1 in boys), testing to rule out VUR is recommended.
- In the first 3 months of observation in acute pyelonephritis and after exacerbation of chronic pyelonephritis, a clinical urinalysis is performed 1 time in 10 days, within 1-3 years - monthly, then - 1 time in 3 months. The presence of a portable urine analyzer at home allows you to take an analysis avoiding contact with infectious patients (in clinics and laboratories).
- Urine culture is performed when leukocyturia appears and / or with unmotivated temperature rises without catarrhal phenomena.
