Urinary Tract Infection In Children The urinary tract consists of the organs in our body that produce, store, and evacuate urine. Urine is produced in the kidneys and travels down to the bladder through the thin tubular structures called ureters. The bladder stores the urine until it is emptied through the urethra, a tube that links the bladder to the skin, from where we urinate.
Urinary Tract Infection (UTI) Normal urine has no bacteria in it and there is a constant forward flow of urine which ensures that no bacteria enter the urinary tract. Still, bacteria may get into the urine through the urethra and travel up into the bladder. When the urine gets colonised by bacteria and reach up to the bladder, it is called a UTI. Rarely bacteria in the blood can also reach the kidneys or bladder and cause UTI.
Can Children Develop UTI? Yes, UTI can happen at any age. UTIs are a relatively common infection during childhood. As many as 8 in 100 of girls and 2 in 100 of boys will get UTIs. Children have a greater risk of kidney damage due to UTI than adults. Younger children have a unique set of risk factors for UTI which need to be targeted in a relevant manner. Book an appointment with the best Pediatric Surgeon and Pediatric Urologist in Gurgaon at Fortis Memorial Research Institute f FMRI.
Types Of UTI? Lower UTI
Upper UTI
Urethra Urethritis Bladder
Kidney Infection Pyelonephritis Prostrate
Reasons Of UTI in Children
Most children develop UTI due to migration of bacteria from the skin in to the bladder. However there are various risk factors in children which can predispose a child to UTIs. Some of them are as poor hygiene, bad habits, constipation, obstruction to passage of urine or the reflux of urine from bladder to kidneys. UTIs are caused by bacteria from stool entering the urethra. It often occurs when a child wipes their bottom, and soiled toilet paper comes into contact with their genitals. This is more of a problem for girls than boys, because girls' bottoms are much nearer the urethra. In boys, the secretions of the glans (tip of penis) may get collected under the foreskin (especially if the foreskin is not retracted and cleaned properly). These secretions (smegma) may get infected and can lead to UTI in boys.
Can UTIs Be Dangerous
UTI is usually a non-threatening infection which responds well to proper antibiotic treatment. However in children recurrent or severe episodes of UTI can cause permanent kidney damage (scarring of kidneys), growth retardation, high blood pressure and anaemia. Younger children have greatest risk for kidney damage from UTIs, especially if they have some unknown urinary tract abnormality.
Symptoms Of UTI?
During UTI the mucosa of bladder and urethra becomes swollen and red. Older children may complain of pain in the lower tummy or pain while passing urine (dysuria). Children tend to avoid passing urine due to pain and this leads to dribbling of urine and increased frequency of urination. The urine may appear turbid or cloudy and may leave a bad smell. UTI is usually associated with high grade fever. Smaller children may cry excessively when they urinate. If the child is too young to tell how he or she feels, the signs are likely to be vague and not linked to the urinary tract. The child may present with just high grade fever with reduced appetite and irritability.
Diagnosis Of UTI
The diagnosis of UTI is confirmed by urine test. Collecting a urine sample from a child can sometimes be difficult. It is important to keep bacteria from the skin from getting into the sample. In children who are toilet trained, a urine sample can be collected using a sterile bottle provided by the laboratory. Sample is collected by holding the bottle in the stream of urine while the child is urinating. Nothing should touch the open rim of the bottle as this leads to bacteria on the skin contaminating the sample. For smaller children a urine collecting bag can be attached to the skin but the results may not be very accurate. In such cases, a urine sample can be obtained by inserting a small plastic tube called a catheter into the child's urethra. Presence of pus cells and bacteria in the urine indicate a UTI. This test takes only a few minutes. However the diagnosis is confirmed on detecting bacteria in a urine culture. The bacteria can then be identified and tested to see which drugs will work best. However it may take 48-72 hours to obtain the result from the urine culture.
Duration Of Recovery From UTI
Smaller children and sick babies should be treated at hospital with injectable medicines. However in most cases, UTI can be treated at home. The child should be encouraged to drink plenty of fluids and urinate frequently. The child's condition usually improves within 24 to 48 hours of treatment. However, it is very important that they finish the whole prescribed course of antibiotics to prevent the infection recurring. In case the baby appears sick or drowsy, is unable to hold medications due to persistent vomiting, suffers from dehydration and reduced urine output or does not improve in 48 hours, the child should be immediately brought back to the hospital.
General Preventions From UTI
It isn't possible to prevent all childhood urinary tract infections (UTIs), but there are some things one can do to reduce the risk of their child getting one. Draining the bladder often is one of the body's best defences against UTIs. Drinking more fluids will increase urine flow to flush infection out of the body. Children should also be encouraged to avoid “holding it in� if they need to urinate and should be instructed to pass urine frequently. Encourage girls to wipe their bottom from front to back rather than back to front and boys to clean around their foreskin regularly. Include enough fibre in your child's diet to help prevent constipation. Frequent change of diapers in small children also decreases the risk of UTI. Provide loose-fitting cotton underwear for your child instead of underwear made from nylon or other synthetic materials.
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