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

Causes

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

Risk Factors

Factors that may increase your child's chance of developing 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

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

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 your 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 that is 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

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

UTIs can be uncomfortable and may cause fever. Your doctor may recommend some over-the-counter medication for your child. They may include:

Acetaminophen
Ibuprofen

Follow the instructions on the package.

Note : Aspirin is not recommended for children or teens with a current or recent viral infection. This is because of the risk of Reye's syndrome . Ask your doctor which other medicines are safe for your child.

Pyridium may also be prescribed. It helps relieve pain associated with UTIs.

If your child is diagnosed with a UTI, follow your doctor's instructions .

Prevention

To help reduce your child's chances of developing a urinary tract infection, take the following steps:

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 http://familydoctor.org

National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

CANADIAN RESOURCES

About Kids Health http://www.aboutkidshealth.ca

Health Canada http://www.hc-sc.gc.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 (UTI) prevention. Cincinnati Children's Hospital Medical Center website. Available at: http://www.cincinnatichildrens.org/health/u/uti-prevention/ . Updated January 2010. Accessed May 15, 2013.

Urinary tract infection in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 12, 2013. Accessed May 15, 2013.

Urinary tract infections—urological overview. The Cleveland Clinic Health Information Center website. Available at: http://my.clevelandclinic.org/disorders/urinary%5Ftract%5Finfections/urology%5Foverview.aspx# . Accessed May 15, 2013.

12/5/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Pohl A. Modes of administration of antibiotics for symptomatic severe urinary tract infections [review]. Cochrane Database of Systematic Reviews. 2007(4). DOI: 10.1002/14651858.CD003237.

11/6/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Craig JC, Simpson JM, Williams GJ, et al. Antibiotic prophylaxis and recurrent urinary tract infection in children. N Engl J Med. 2009;361(18):1748-1759.

Revision Information

Reviewer: Michael Woods
Review Date: 05/2013 -
Update Date: 05/15/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Reston Hospital

Patient Care Services

Find a Doctor

Patients & Visitors

About Us

Career Center

Health Library

For Clinicians