Urinary Tract Infection in Children

What causes UTI in children?
Constipation: If the child has habit of holding of stool for long time and it keeps kids from delay emptying of bladder, pressure on the bladder from backed- up poop can cause urine to be trapped, resulting in urine infection. Constipated kids sometime experience poop-leak which makes good hygiene difficult.

Hygiene: Child needs to carefully clean the skin after passing of stool, as bacteria can easily pass from skin to the opening of urethra. Small kids need to change the diaper as soon as it gets soiled.

Irritants: Skin irritates from chemicals like bubble baths or chemicals used in swimming pools, soap with fragrance, or scents or colors used in the bath tub. All these irritants help to develop UTI.

Excessive use of gadgets in kids: After using gadgets for prolonged periods, the child forgets to pass stool and urine, or holds urine and stool, so as not to miss any program/games. These habits of holding stool and urine help in developing UTI. A child may even hold stool and urine due to fear of teachers and unhealthy/unhygienic washrooms at school.

Genetics: UTI sometimes run in families. This is especially significant when there is a history of vesicoureteral reflux (VUR) in a family. Bladder infection is much likely to progress to pyelonephritis in kids with VUR.

What are the symptoms of UTI?
Most kids with UTI experience some, but not all, of these signs and symptoms:

• Blood in the urine or diaper
• Foul or strong urine odor/cloudy urine on long standing
• Urgency about going to bathroom
• Pain or burning with urination
• Pressure or pain in the lower pelvis or lower back
• Wetting problems in pants or bed
• Poor feeding, lethargy, jaundice (in Infants)

• Fever with chills/shaking
• Nausea and vomiting
• Pain in the side (flank) or back
• Severe pain in the belly area

Urine test includes: a) dipstick, b) microscopy, and c) culture and sensitivity

How to collect urine:
1. Mid-stream urine 2. Bag collection 3. Catheterization 4. Suprapubic aspiration
Urine specimen should be promptly plated within one hour of collection. If there is a delay, the sample can be stored in a refrigerator at 4 ºC for 12‐24 hours.

Blood test: CBC, renal function

Imaging: Renal bladder ultrasound, MCU (micturating cystourethrography), nuclear scan.

When should you bring your child to the doctor for UTI?
If you think that your child is having the above symptoms, don’t delay in seeing your pediatrician. They will do the test for infection and decide on the best course of treatment.

How do you treat?
• Antibiotics are the best treatment. Your treating doctor will decide the best antibiotics with proper dose and duration.
• Keep your child well hydrated.
• Over-the-counter treatment will not treat and cure the actual urine infection.

What happens if UTI is left untreated?
If urinary tract infection is not treated in time, it can lead to infection in the kidneys, as well as in the blood stream. Blood stream infection can cause life-threatening complication, and even permanent damage to the kidneys.
• Avoid giving bubble baths.
• Use loose-fitting underpants and clothing.
• Increase your child’s intake of fluids.
• Encourage your child to go the bathroom several times every day.
• Keep your child’s genital area clean. Teach your child to wipe the genital area from front to back to reduce the spread of bacteria.

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