Urinary Tract Infections

What is urinary tract infection (UTI)?

The urinary tract is an organ that make, store and get rid of urine. This urinary tract includes kidneys, bladder and urethra. Bacteria that enter the urethra are flushed out through urination. When bacteria are not expelled out of the urethra, they may go in the urinary tract and multiply, causing a urinary tract infection. These bacteria can cause infection anywhere in the urinary tract. When the infection is pertinent to the kidneys it is called pyelonephritis and a bladder infection is called cystitis and an infection in urethra is called urethritis.

It is estimated that 8% of girls and 2% of boys get a urinary tract infection by age five. Since a girl’s urethra is shorter and bacteria from the anus can easily enter the vagina and urethra, UTIs are more common in girls. Sometimes the symptoms of UTI in infants may be hard to trace and can turn to a kidney infection. Early diagnosis and monitoring can help your children get relieved from the infection in a few days’ time.

Causes of UTI

The most common cause of UTI is a bacterium called E.coli which enters the urinary tract from skin around the anus or vagina. Most of the infections happen when bacteria spread from the anus to the urethra.

Symptoms of UTI

The main symptoms of UTI include pain in the lower belly, back or side and an urgent need to pee. Older kids have distinct symptoms and younger kids may not be able to reveal the symptoms. Infants with UTI will be fussy, have a fever and show little interest in eating. Some of the other symptoms of UTI include:

• Burning or pain when your child pees
• Foul-smelling or cloudy pee
• Waking up night often to go to bathroom
• Able to pee only a few drops but have an urgent sensation
• Nausea
• Diarrhea

Kidney infection has some serious symptoms like a high grade fever, severe abdominal pain, chills with shaking, fatigue and irritability.

Risk factors for UTI in children

UTIs usually happen during toilet training. The following factors can increase the risk of UTIs in children.

• Any forms of structural deformity or blockage in one of the organs of the urinary tract
• Abnormal function of the urinary tract
• Birth defects
• Bubbles in bath (for girls)
• Tight-fitting clothes (for girls)
• Improper wiping techniques
• Poor hygiene
• Family history of UTIs

 Diagnosis of UTI

The following diagnostic tests will be performed to diagnose a urinary tract infection.

1. Urine Analysis: The urine sample is collected and tested for the presence of bacteria and pus using a microscope.

2. Urine culture: The sample is cultured for 24-48 hours to identify the type of bacteria so that prompt treatment can be initiated.

For children who are not toilet trained, urine samples are collected by taping a plastic bag to the child’s genitals. In some cases, a catheter will be inserted into the tip of a boy’s penis or into a girl’s urethra and into the bladder to collect urine.

If the UTI turns to be severe and the cause of UTI is due to an abnormal urinary tract, your pediatrician may refer your child to a nephrologist. Some imaging tests like ultrasound, Voiding cystourethrogram (VCUG), nuclear scan, CT and MRI will be performed depending upon the location and intensity of the infection.

Treatment of UTI

In order to prevent kidney damage, prompt treatment with antibiotics is necessary. Follow the course of medications as advised by your physician. Hospitalizations are required if the child is less than six months old, has a high fever, kidney infection and has severe vomiting and dehydration. Prompt treatment helps your child to recover from UTI quickly. However in case of any structural deformities in the urinary tract, a long term treatment is necessary.

Prevention

UTIs can be prevented by practising proper hygiene and doing the following.

1. Tight fitting clothes and underwear should be avoided in female children.

2. Make sure that your child receives lots of fluids.

3. In younger children, frequent changing of diapers is necessary.

4. Teach your children to follow proper hygiene to maintain a clear genital area.

5. Educate your children to use the toilet frequently rather than holding the urine for longer duration.

 

6. Teach children safe wiping techniques after bowel movements.