Urinary Tract Infections in Children

Urinary Tract Infection is one of the commonest pediatric infections in childhood with up to 8% of children having at least one UTI between 1 month to 11 years. It causes distress to the baby and to parents.UTI has a small chance of causing kidney damage if left untreated. It is very commonly missed as it can present with fever alone and no other localizing source.

Reasons

UTI occurs when bacteria gets into the urine and travels up to the bladder. Normal urine is sterile but infection can happen from bacteria found on the skin or from local bacteria found in the rectal area or in stools. The improper technique of washing after defecation , especially in girls if washing is from back to front the bacteria present In stools can contaminate the urethra resulting in bacteria ascending into the bladder as the urethra is very short in girls.

Some children develop behaviors where they hold onto their urine or stools for too long increases the risk of them developing a UTI

Tight foreskin (phimosis) in boys prevents the bladder from emptying fully resulting in stagnant urine which could give rise to infection.

Poor toilet and hygiene practices

Constipation can stop the bladder from being emptied fully. Bacteria can grow well in stagnant urine

Common Symptoms

Older children have pain in the lower abdomen or back, frequent urination, crying or pain while urinating, bedwetting or passing only drops of urine, blood in urine, etc

If the baby is too small the symptoms can be varied like only low-grade fever, bad smell in diaper, foul-smelling or cloudy urine

Rarely, it can be fever with vomiting and in newborns with jaundice and seizures

Types of UTI

Basically 2 types of UTI

  • Cystitis(lower UTI) -when only the bladder is infected
  • Pyelonephritis(Upper UTI) – If kidney is involved

Preventive measures

Bacteria that cause UTIs most commonly come from the bottom or from bacteria found in stools, so it is important that when girls are wiping after they go to the toilet, they wipe front-to-back (vagina-to-bottom) so that they don’t spread bacteria to the urethra.

Children should develop the habit of not holding back urine or motion too long to reduce the risk of them developing a UTI. If parents notice such habits its best to inform the teachers to monitor them,especially children with recurrent UTI s

Constipation needs to be treated therefore ensuring the bladder is being emptied of urine fully and frequently can help prevent a UTI

Ensuring your child is drinking well and giving a high fiber diet helps prevent constipation and increases bladder emptying, reducing the risk of a UTI.

 

Treatment

Based on symptoms a urine test will be ordered by the doctor and a decision on the need and duration of antibiotics made based on test results.

 

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Dr. Manosh Karun,

Specialist Pediatrician

Aster Clinic, Silicon Oasis

 

 

 

 

 

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