UTI

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UTI



Infection of the urinary system is a fairly common type of bacterial infection occurring in children. However due to its non-specific symptomatology, it is often underdiagnosed and thus inadequately treated. Most often it is caused by bacteria that invade the urinary tract by passing up the urethra into the bladder. The most common types of bacteria causing urinary infections are those that usually live on the skin near the opening of the urethra. These include common skin bacteria, as well as those that come from the child’s anus.

Contributing Factors:



Some children with UTI appear to have lower resistance to the bacteria commonly found on the skin near the opening of the urethra. The reason for this is not known, but it seems that among children who have had bladder infections, some are more likely than others to have recurrences.

  1. Unusual voiding and bowel habits may contribute to UTI in children. These children are often helped by establishing a schedule which allow for complete and unhurried emptying of their bladder every 3-4 hours.
  2. Since constipation can be a contributing factor to UTI, initiating a bowel program, which involves increased fiber to the diet can help produce a more regular pattern of bowel movements.
  3. Hygiene of the perineal skin is important to prevent excessive accumulation of bacteria on that skin.
  4. Children who have repeated urinary tract infections for no obvious reason may require continuous low dose medication for months or years. These problems usually disappear as the child enters puberty and if no urinary tract abnormality was present at the time of the initial evaluation, these children are not at greater risk for serious problems in the future. Signs and symptoms of UTI can be different in every child:

Symptoms of UTI:



  1. Infants and Toddlers may become irritable, have fever, vomiting and diarrhea or may develop feeding problems with failure to gain weight.
  2. Toilet Trained Children may develop wetting episodes, complain of burning or frequency of urination, fever, abdominal pain, back or flank pain or even blood in the urine.

Treatment of urinary tract infection includes:



  1. Treatment of urinary tract infections should not only include treatment of the episode of infection but attempts must be made to look for the reasons which have led to the failure of normal defence mechanism.
  2. Investigations of a child with UTI include certain tests of blood and urine to help treat the infection episode and certain tests for evaluation of the child’s urinary tract to identify any urinary tract abnormalities. This evaluation usually consists of a kidney ultrasound and bladder x-ray (VCUG or MCU).
  3. Antibiotic medication given for a period of one to two weeks. In some cases these medications are continued on a daily basis for many months.