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Urinary Tract Infection (UTI)

The urinary system consists of the two kidneys, two ureters, the bladder and the urethra. Normally, this is a sterile internal system however in case bacteria enters the bladder or kidney this can cause an infection, called a Urinary Tract Infection (UTI).

Kidney infection in UTI is a serious medical condition and can damage the kidneys permanently if left untreated.


What causes Urinary Tract Infection (UTI)?

E. coli bacteria are found to be the most common cause of UTI in children.

Risk factors — These factors increase the risk of UTI in children:

  • Age – Boys less than 1 year and girls less than 4 years of age.

  • Uncircumcised – There is a 4 to 10 times increased risk if the child is not circumcised.

  • Catheter – Prolonged use of bladder catheter.

  • Congenital defect – Underdeveloped urinary tract.

  • Bladder problems – Bladder is not functioning properly.

  • Previous case – Having UTI once increases the risk of recurrence.


What are the symptoms of Urinary Tract Infection (UTI)?

Symptoms of a urinary tract infection depend on the child's age.

Older children — Children older than two years often have:

  • Pain or burning when urinating

  • Frequent need to urinate

  • Pain in the lower abdomen or sides of the back

  • Fever (higher than 100.4ºF or 38ºC)


Younger children — Symptoms in children younger than two years may include one or more of the following:

  • Fever, which may be the only symptom

  • Vomiting or diarrhea

  • Irritability or fussiness

  • Poor feeding, poor weight gain


Signs of a UTI in babies and young children can include:

  • Fever (with no obvious cause such as a rash or cough)

  • Irritability

  • Poor feeding

  • Vomiting

  • Being lethargic (very tired and lacking energy) and ‘not quite right’

  • Poor weight gain

  • Prolonged jaundice in newborn babies

Sometimes a simple UTI can become more serious in young babies or children when the infection spreads to involve the kidneys or spreads into the blood stream. If this happens, you need to see your GP (general practitioner) or after-hours medical centre urgently. Signs of this can include:

  • High fever

  • Abdominal pain

  • Persistent vomiting

  • Shivering

  • Drowsiness

 

How is Urinary Tract Infection (UTI) diagnosed?

  • First aid - If you are concerned that your child has a UTI, make an appointment with the child's doctor or nurse within 24 hours.

  • Urine testing — A urine sample is needed to determine if the child has a UTI. After obtaining the urine, a urine dipstick test is usually done in the office. If the test is positive for a UTI, the doctor or nurse will send the urine sample to a lab for urine culture to confirm the diagnosis.

  • Imaging tests — Imaging tests, such as ultrasound or x-ray, can show if a child's urinary system did not form correctly before birth. If the urinary system is abnormal, a child is more likely to have UTIs. Testing may include a kidney ultrasound and a voiding cystourethrogram (VCUG).

  • Kidney ultrasound — Ultrasound uses sound waves to create a picture of the kidneys. During the test, gel is applied to the skin on the child's back and abdomen and a small wand-like device is pressed against the body.

  • Voiding cystourethrogram — A voiding cystourethrogram (VCUG) is an x-ray test that shows the outline of the child's bladder and urethra. The test can also show if urine flows from the bladder backwards into the ureters or kidneys; this is called vesicoureteral reflux. Reflux may increase the chance that a child will have kidney infections.


How is Urinary Tract Infection (UTI) treated?

  • Antibiotics are used to treat UTIs. The best antibiotic depends upon the child's age, the germ that caused the UTI, and the resistance that germs have.

  • If the child is less than two months old, or if the child is vomiting and unable to take medicine by mouth, it may be necessary for the child to be admitted to the hospital for treatment with intravenous (IV) antibiotics.

  • Antibiotics are usually prescribed for a total of five to 14 days. In all cases, it is important for the child to take each dose of the antibiotic on time and to finish all of the medicine.


Outlook

With treatment, the outlook for a child with a UTI is excellent. UTIs can easily be treated with antibiotics, and the risk of complications is low.

However, in UTI cases, prompt diagnosis and treatment is very important. If left untreated, UTIs (particularly upper UTIs) can cause a number of serious problems, including kidney damage or even kidney failure.

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