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Urinary Tract Infections in Childhood

(UTI in Childhood)

Definition

The urinary tract carries urine from the kidneys to the outside of the body. It includes the kidneys, bladder, and tubes that connect them. The tubes from the kidney to bladder are called ureters. The tube from the bladder to the outside of the body is called the urethra. A urinary tract infection (UTI) is an infection in any of these structures.

The Urinary Tract

si55551330_urinary tract child.jpg
Copyright © Nucleus Medical Media, Inc.

Causes    TOP

UTIs are caused by bacteria. The bacteria may enter the bladder or the kidneys.

Risk Factors    TOP

Factors that may increase your child's chance of a urinary tract infection include:

  • Abnormalities of the urinary tract, including:
    • Vesicoureteral reflux—urine flows backwards from the bladder up into the kidneys
    • Urinary obstruction—something is blocking or slowing the flow of urine
  • Holding urine for long periods of time
  • Not fully emptying the bladder
  • Poor hygiene and toilet habits
  • Clothing that is too tight, especially if it is not cotton
  • Family history of UTIs
  • Uncircumcised penis

Symptoms    TOP

Symptoms include:

  • Feeling the need to urinate frequently
  • Only producing a small amount of urine
  • Burning or painful urination
  • Fever
  • Diarrhea
  • Irritability
  • Fatigue
  • Stomachache
  • Foul-smelling urine
  • Blood in the urine
  • Potty-trained children wetting themselves

Diagnosis    TOP

The doctor will ask about your child's symptoms and medical history. A physical exam will be done. The doctor may also ask for a urine sample. Follow the doctor's directions on collecting your child's urine.

Your child's bodily fluids may need to be tested. This can be done with:

  • Urinalysis—a laboratory examination of a urine sample
  • Urine culture—to identify the specific bacteria involved
  • Complete blood count and other blood tests if your child has a fever

Imaging tests may be ordered if your child is a boy with a UTI or a girl after her second UTI. These infections may be associated with problems in the urinary tract. The test may include ultrasound or specialized scans and x-rays.

Treatment    TOP

Talk with your doctor about the best treatment plan for your child. Treatment options include:

Antibiotics

Antibiotics will help fight the bacteria that is causing the infection. Your child will most likely be given antibiotic pills or liquid to take by mouth. Finish the medication even if your child is feeling better.

Some severe infections may need to have antibiotics delivered by IV or an injection.

Fluids

Encourage your child to drink plenty of fluids. This will help to flush the bacteria out of the system. It will also decrease the concentration of the urine. This may make it more comfortable to urinate.

Pain and Fever Relief    TOP

UTIs can be uncomfortable and may cause fever. Your child's doctor may advise over-the-counter or prescription pain relievers.

Follow the instructions on the package.

Note —Aspirin is not recommended for children with a current or recent viral infection. Check with the doctor before giving your child aspirin.

Prevention    TOP

To help reduce your child's chances of a urinary tract infection:

  • Talk to your child's doctor if your child has an abnormality of the urinary system. Your child may need surgery.
  • Make sure that girls learn to wipe from front to back.
  • Encourage your child to go to the bathroom often—at least several times a day.
  • Retract the foreskin of the penis on a regular basis. This will help to keep the area clean.
  • If your child has UTIs often, the doctor may prescribe antibiotics. This may help to prevent a new infection.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://familydoctor.org
National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

References:

American Academy of Pediatrics (AAP) clinical practice guideline on diagnosis and management of initial UTI in febrile infants and children aged 2 to 24 months. Pediatrics. 2011 Sep;128(3):595.
Urinary tract infection. Cleveland Clinic website. Available at:
...(Click grey area to select URL)
Accessed May 15, 2013.
Urinary tract infection (UTI) in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 12, 2016. Accessed September 27, 2016.
Urinary tract infection (UTI) prevention. Cincinnati Children's Hospital Medical Center website. Available at:
...(Click grey area to select URL)
Updated January 2010. Accessed May 15, 2013.
12/5/2007 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections. Cochrane Database of Syst Rev. 2007;(4):CD003237.
11/6/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Craig JC, Simpson JM, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med. 2009;361(18):1748-1759.
Last reviewed March 2017 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 5/5/2014

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