Urinary tract infection (UTI) in children

About

Urinary tract infections (UTIs) are a fairly common problem in children, affecting both males and females. UTIs account for 10-14% of all infections in children. Symptoms of UTI in children include pain or burning while passing urine, lower abdominal pain, frequent urge to urinate, and fever. Children with UTIs may also experience nausea, vomiting, and unusual looking urine. If left untreated, UTIs can lead to more serious kidney infections and an increased risk of kidney damage. The best way to prevent UTI in children is to ensure proper hygiene and regular visits to the doctor for any symptoms. Treatment typically consists of antibiotics and may include pain medications as well.

Symptoms

The most common symptoms of urinary tract infection (UTI) in children are frequent and painful urination, lower back or abdominal pain, bed-wetting, and cloudy or bloody urine. Other symptoms can include a fever, vomiting, and an unusual odor or discoloration to the urine. In some cases, children may have no symptoms at all.

Causes

The two main causes of urinary tract infections (UTI) in children are bacteria and urinary tract abnormalities. Bacteria are the most common cause of UTI in children. Most bacteria originate within the intestine and travel up the urethra to the bladder where they multiply and cause infection. Risk factors for bacterial UTIs can include recent antibiotic use, not voiding (peeing) regularly, poor hygiene practices, holding of urine, constipation, and a short urethra.

Urinary tract abnormalities can also cause UTI in children. These include birth defects, a narrowing of the urethra, or incomplete bladder emptying. Additionally, girls are more likely to get UTIs because they have a shorter urethra than boys, which makes it easier for bacteria to reach the bladder.

Other risk factors include any underlying health conditions, such as diabetes, a weakened immune system, and being uncircumcised.

Risk factors

The risk factors for urinary tract infection (UTI) in children include:

Gender – Females are more at risk than males due to the shorter urethra
Age – Children between 2 and 5 are most commonly affected
Anatomy – Children with certain birth defects, such as vesicoureteral reflux, can increase their chance of getting a UTI
Hygiene – Poor hygiene practices can increase the chance of getting a UTI
Diet – Eating a diet high in sugar and acid increases the chances of bacterial growth in the urinary tract
Health Conditions – Conditions such as diabetes, kidney stones, and obesity can increase the chances of getting a UTI
Medical Procedures – Certain medical procedures involving catheters, as well as a history of frequent UTIs, can increase the risk of getting a UTI

Diagnosis

A Urinary Tract Infection (UTI) in children is typically diagnosed by a physical exam and a urine sample. During the physical exam, a pediatrician will check for any signs of infection such as fever, pain, or a tender abdomen. If there are any signs of infection, a urine sample will then be collected to test for the presence of bacteria and white blood cells. The urine sample will also be tested for any other abnormalities such as protein, sugar, and/or blood. Finally, a urine culture will be performed to determine the precise bacteria causing the infection and the appropriate antibiotics that should be used to treat it.

Sub-types

Urinary tract infections (UTI’s) in children can be divided into 4 subtypes according to the source of infection and the site of infection:

Urethritis: This is an infection of the urethral area, which is the tube that carries urine from the bladder to the outside of the body. Symptoms may include pain or discomfort when urinating, frequent urges to urinate, and discharge from the urethra.
Cystitis: This is an infection of the bladder, which holds urine. Symptoms may include pain in the lower abdomen, frequent urges to urinate, and cloudy or bloody urine.
Pyelonephritis: This is an infection of the kidneys. Symptoms may include fever, chills, nausea, vomiting, and pain in the back or side.
Vesicoureteral reflux (VUR): This is an abnormal backward flow of urine from the bladder to the kidneys. Symptoms may include recurrent UTIs, fever, and bedwetting.

It is important for parents to bring their child for medical examination if they have any of these symptoms to ensure the child receives the appropriate care and treatment.

Treatments

Treatment for urinary tract infections (UTIs) in children depends on the severity of the infection, the child’s age, and other factors. Generally, the treatment of UTIs in children includes the following:

Oral antibiotics: Depending on the severity and type of infection, a doctor may prescribe antibiotics in pill, liquid, or even in a suppository form.
Pain relief: A doctor may prescribe an anti-inflammatory medication to help alleviate discomfort associated with UTIs.
Fluid intake: It is important to drink plenty of fluids to help flush out the infection.
Diet management: Depending on the type of UTI, a doctor may recommend a special diet to help the body heal.
Surgery: In severe cases, surgery may be necessary to correct any structural issues in the urinary tract or bladder.
Other treatments: A doctor may recommend other treatments such as cranberry extract, probiotics, or herbal remedies to help hasten recovery.

Prevention

To reduce the risk of UTI in children, it is important to practice good hygiene and hydration. Parents should ensure that their children practice proper hand washing techniques and wash their hands after using the restroom, before eating, and after playing outside. Parents should also encourage their children to drink plenty of fluids to stay hydrated and flush out any bacteria from their urinary system. In addition, parents should ensure that their children wear loose-fitting clothing and cotton underwear to reduce the risk of trapping bacteria. Finally, parents should teach their children to void regularly, empty the bladder completely after voiding, and not to hold their bladder for too long.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Urinary Tract Infections (UTI) in children. Boys are more likely to present with fever, a bulging fontanelle, and focal abdominal tenderness. In girls, UTI can often be asymptomatic and is more likely to present with nonspecific systemic symptoms such as irritability, fever, and vomiting. In terms of management, it is important that boys be evaluated for further imaging and/or referral to a urology specialist. Girls, on the other hand, typically can be managed with antibiotics and reassessment. Additionally, boys are more likely to have a higher rate of recurrence of UTI than girls.

Nutrition

Nutrition plays an essential role in the successful management of urinary tract infection (UTI) in children. Eating a healthy, balanced diet with lots of fruit, vegetables, and other nutrient-rich foods can help keep the urinary tract healthy. Increasing fluid intake to help flush out bacteria may also be beneficial. For children with chronic UTI, specific dietary recommendations may be made to reduce the risk of recurrence. One recommended dietary modification is to reduce the intake of simple sugars which can increase the risk of recurrent UTI. Additionally, probiotics may reduce the risk of UTI recurrence. Therefore, it is important for children with UTI to follow a nutritious diet and increase their intake of probiotics in order to maximize the chances of a successful management of UTI.

Physical Activity

Physical activity is thought to help prevent urinary tract infections (UTIs) in children by promoting healthy bladder habits. Exercise helps promote a healthy bladder by strengthening the surrounding muscles, this makes it easier for children to both empty and hold their bladder. This reduces the amount of time urine is in contact with bladder walls, which can reduce the chance of bacteria buildup that can cause UTIs. Exercise may also improve immunity, which can reduce the chances of infection. Additionally, physical activity can help to reduce constipation and improve general hydration, both of which are important in reducing bacteria buildup that can cause UTIs.