Urinary tract infections

WHAT IS A URINARY TRACT INFECTION?

A urinary tract infection (UTI) is a bacterial infection affecting the bladder or the kidneys.

HOW DO WE SUSPECT UTI IN A CHILD?

In babies UTI may cause

  • fever
  • restlessness
  • loss of appetite, the baby takes less food than usual
  • vomiting

Older children may present with

  • fever
  • pain lower in their belly
  • wanting to pee all the time
  • urgent need to pee
  • pain during urination

Children with UTI don’t necessarily have all the symptoms. Sometimes they present with only one of them!

IS UTI A SERIOUS INFECTION?

When the infection affects only the bladder, it is called cystitis. When the ureters or the kidneys are affected, we call it pyelonephritis. Pyelonephritis is a potentially aggressive and serious infection. Children with pyelonephritis look very sick, have high fever with chills, lower back pain and vomiting.

WHY DO CHILDREN GET UTIS?

UTI is much more common in girls. Only during the first year of life boys are more frequently affected. Risk factors for a urinary tract infection are:

  • congenital anomalies of the urinary tract (a narrowing at some point or some other problem in the formation of the kidney)
  • urine flowing back from the bladder into the ureter (this is called reflux)
  • being female
  • mother having a history of frequent UTIs herself
  • wiping from “back to front” (poor toilet hygiene)

CAN MY CHILD GET A UTI FROM A PUBLIC TOILET?

It’s a common misconception that you get UTI from a toilet. The bacteria we find in a UTI are already living in the child’s intestine and perianal area. They cause an infection when they gain access to the urinary tract. That’s why proper toilet hygiene is essential in preventing UTIs and more precisely to teach the girl to wipe from “front to back”.

HOW CAN WE BE SURE IT’S A URINARY TRACT INFECTION?

A urine sample is analyzed and then cultured. Urinalysis may strongly suggest a UTI. Culture confirms the result and identifies the specific bacteria which caused the infection.

HOW ARE UTIS TREATED?

UTIs are treated by giving simple antibiotics for a few days, most of the time.

WHY SO MUCH FUSS ABOUT UTIS IN CHILDREN?

The reason paediatricians get anxious about UTIs, is the possibility of a urinary tract anomaly or reflux causing the UTIs. In these cases it is imperative to discover the problem in order to preserve good renal function, either with medications or surgery. That is why sometimes we order a renal ultrasound or other imaging studies of the urinary tract.

Author: Dimitris Anastasiou